Temperature management during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

Area of Science:

• Oncology
• Surgical Oncology
• Hyperthermia Therapy

Background:

• Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) offers curative potential for peritoneal surface malignancies.
• Heating chemotherapeutic agents increases efficacy but risks severe systemic hyperthermia.
• Current cooling protocols for CRS-HIPEC are non-standardized, leading to unpredictable temperature fluctuations.

Purpose of the Study:

• To describe the physiological mechanisms of hyperthermia during CRS-HIPEC.
• To outline challenges in temperature management during CRS-HIPEC.
• To present methods for avoiding hypothermia and hyperthermia during CRS-HIPEC.

Main Methods:

• Review of physiological processes and mechanisms of hyperthermia in CRS-HIPEC.
• Analysis of factors contributing to hyperthermia risk, including blood transfusions and perfusion duration.
• Examination of existing cooling protocols and their impact on patient temperature.

Main Results:

• Failure to reach 38°C post-chemo-perfusion correlated with worse survival in a study of 214 adults.
• Although not statistically significant, not maintaining 38°C for 30 minutes also showed a trend towards worse survival.
• Temperature management during CRS-HIPEC is critical for treatment efficacy and patient outcomes.

Conclusions:

• Maintaining a stable core body temperature is essential during the hyperthermic phase of CRS-HIPEC.
• Standardized temperature management protocols are needed to mitigate risks of severe hyperthermia and hypothermia.
• Further research is required to optimize temperature control strategies for improved CRS-HIPEC outcomes.