Title of article :
Hemodynamic variations during thoracic and abdominal stop-flow regional chemotherapy
Author/Authors :
G. Varrassi، نويسنده , , S. Guadagni، نويسنده , , A. Ciccozzi، نويسنده , , F. Marinangeli، نويسنده , , T. Pozone، نويسنده , , A. Piroli، نويسنده , , I. Marsili، نويسنده , , A. Paladini، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 2004
Pages :
7
From page :
377
To page :
383
Abstract :
Aims. The aim of this study was to study hemodynamic modifications during thoracic and abdominal stop-flow regional chemotherapy and to evaluate the need for routine hemodynamic monitoring during such kind of procedures. Methods. Thirty patients, aged 17–67 years, ASA physical status II–III, scheduled for thoracic (group A, n=15), and abdominal (group B, n=15) stop-flow regional chemotherapy were enrolled. Heart rate (HR), electrocardiogram lead I and V5, end tidal carbon dioxide (ETCO2), arterial oxygen saturation (SaO2), systolic, diastolic and mean arterial pressure (SBP, DBP, MAP), mean pulmonary arterial pressure (MPAP), pulmonary capillary wedge pressure (PCWP), central venous pressure (CVP), cardiac output (CO), stroke volume (SV), stroke index (SI), systemic vascular resistance (SVR), pulmonary vascular resistance (PVR), left cardiac work (LCW), right cardiac work (RCW), left cardiac work index (LCWI), right cardiac work index (RCWI), cardiac index (CI), and body O2 consumption (VO2) were recorded. Results. After aortic and inferior vena cava endovascular occlusion (T1), a significant reduction of CO and SV, associated with an increase of CVP, MAP, PAPM and PCWP were observed. A concomitant reduction of CI and increase of SVR and PVR were registered. The VO2 was significantly reduced compared to basal values in both groups. After deflating aortic and vena cava balloons (T2), CO, SV and CI increased with respect to basal value (p<0.05), whereas MAP, CVP, PAPM, PCWP and calculated parameters (SVR, PVR) showed a significant reduction compared to T1. The oxygen consumption was significantly higher than that of basal values (p<0.05). After hemofiltration (T3), all hemodynamic variables were comparable with the basal values. Modifications of direct and calculated parameters, during the stop-flow period, showed a similar trend in both study groups, without any statistically significant difference. No ST modifications at ECG were noted during all perioperative period. Conclusions. The results of this study have confirmed in both groups, the safety of stop-flow regional chemotherapy procedure, despite endovascular occlusion of the aorta and inferior cava vein. The hemodynamic and oxygenation changes are reversible and did not produce any ST modifications at ECG during all perioperative period. Routine pulmonary artery catheterization is thus unnecessary, except in high cardiac risk patients.
Keywords :
Hemodynamic variations , perfusion , Regional chemotherapy , stop-flow
Journal title :
European Journal of Surgical Oncology
Serial Year :
2004
Journal title :
European Journal of Surgical Oncology
Record number :
510789
Link To Document :
بازگشت