Temperature management during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy
In addition to attaining complete or near complete cytoreduction, the instillation of select heated chemotherapeutic agents into the abdominal cavity has offered a chance for cure or longer survival inpatients with peritoneal surface malignancies. While the heating of chemotherapeutic agents enhance...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.1062158/full |
| _version_ | 1828059264778764288 |
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| author | Maria F. Ramirez Juan Jose Guerra-Londono Pascal Owusu-Agyemang Keith Fournier Carlos E. Guerra-Londono |
| author_facet | Maria F. Ramirez Juan Jose Guerra-Londono Pascal Owusu-Agyemang Keith Fournier Carlos E. Guerra-Londono |
| author_sort | Maria F. Ramirez |
| collection | DOAJ |
| description | In addition to attaining complete or near complete cytoreduction, the instillation of select heated chemotherapeutic agents into the abdominal cavity has offered a chance for cure or longer survival inpatients with peritoneal surface malignancies. While the heating of chemotherapeutic agents enhances cytotoxicity, the resulting systemic hyperthermia has been associated with an increased risk of severe hyperthermia and its associated complications. Factors that have been associated with an increased risk of severe hyperthermia include intraoperative blood transfusions and longer perfusion duration. However, the development of severe hyperthermia still remains largely unpredictable. Thus, at several institutions, cooling protocols are employed during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). Cooling protocols for CRS-HIPEC are not standardized and may be associated with episodes of severe hyperthermia or alternatively hypothermia. In theory, excessive cooling could result in a decreased effectiveness of the intraperitoneal chemotherapeutic agents. This presumption has been supported by a recent study of 214 adults undergoing CRS-HIPEC, where failure to attain a temperature of 38° C at the end of chemo-perfusion was associated with worse survival. Although not statistically significant, failure to maintain a temperature of 38° C for at least 30 minutes was associated with worse survival. Although studies are limited in this regard, the importance of maintaining a steady state of temperature during the hyperthermic phase of intraperitoneal chemotherapy administration cannot be disregarded. The following article describes the processes and physiological mechanisms responsible for hyperthermia during CRS-HIPEC. The challenges associated with temperature management during CRS-HIPEC and methods to avoid severe hypothermia and hyperthermia are also described. |
| first_indexed | 2024-04-10T21:40:27Z |
| format | Article |
| id | doaj.art-81f0b885e6b44614a731f682c96f8bf0 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-10T21:40:27Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-81f0b885e6b44614a731f682c96f8bf02023-01-19T05:11:30ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-01-011210.3389/fonc.2022.10621581062158Temperature management during cytoreductive surgery with hyperthermic intraperitoneal chemotherapyMaria F. Ramirez0Juan Jose Guerra-Londono1Pascal Owusu-Agyemang2Keith Fournier3Carlos E. Guerra-Londono4Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Anesthesiology, Pain Management, & Perioperative Medicine, Henry Ford Health System, Detroit, MI, United StatesIn addition to attaining complete or near complete cytoreduction, the instillation of select heated chemotherapeutic agents into the abdominal cavity has offered a chance for cure or longer survival inpatients with peritoneal surface malignancies. While the heating of chemotherapeutic agents enhances cytotoxicity, the resulting systemic hyperthermia has been associated with an increased risk of severe hyperthermia and its associated complications. Factors that have been associated with an increased risk of severe hyperthermia include intraoperative blood transfusions and longer perfusion duration. However, the development of severe hyperthermia still remains largely unpredictable. Thus, at several institutions, cooling protocols are employed during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). Cooling protocols for CRS-HIPEC are not standardized and may be associated with episodes of severe hyperthermia or alternatively hypothermia. In theory, excessive cooling could result in a decreased effectiveness of the intraperitoneal chemotherapeutic agents. This presumption has been supported by a recent study of 214 adults undergoing CRS-HIPEC, where failure to attain a temperature of 38° C at the end of chemo-perfusion was associated with worse survival. Although not statistically significant, failure to maintain a temperature of 38° C for at least 30 minutes was associated with worse survival. Although studies are limited in this regard, the importance of maintaining a steady state of temperature during the hyperthermic phase of intraperitoneal chemotherapy administration cannot be disregarded. The following article describes the processes and physiological mechanisms responsible for hyperthermia during CRS-HIPEC. The challenges associated with temperature management during CRS-HIPEC and methods to avoid severe hypothermia and hyperthermia are also described.https://www.frontiersin.org/articles/10.3389/fonc.2022.1062158/fullHIPEChyperthermiatemperature controlcooling protocolschemotherapyperitoneal disease |
| spellingShingle | Maria F. Ramirez Juan Jose Guerra-Londono Pascal Owusu-Agyemang Keith Fournier Carlos E. Guerra-Londono Temperature management during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy Frontiers in Oncology HIPEC hyperthermia temperature control cooling protocols chemotherapy peritoneal disease |
| title | Temperature management during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy |
| title_full | Temperature management during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy |
| title_fullStr | Temperature management during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy |
| title_full_unstemmed | Temperature management during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy |
| title_short | Temperature management during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy |
| title_sort | temperature management during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy |
| topic | HIPEC hyperthermia temperature control cooling protocols chemotherapy peritoneal disease |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.1062158/full |
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