Anaesthetic management of extra-pleural pneumonectomy and hyperthermic intrathoracic chemotherapy procedure
Malignant pleural mesothelioma is a rare tumour with survival of 9-17 months after diagnosis. Radical surgical resection by extra-pleural pneumonectomy combined with hyperthermic intrathoracic chemotherapy has shown to improve patient survival and better microscopic tumour control. Anaesthetic manag...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2015-01-01
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| Series: | Indian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2015;volume=59;issue=12;spage=807;epage=810;aulast=Ramegowda |
| _version_ | 1818603329327988736 |
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| author | Jalaja Koppa Ramegowda Mohammed Abdul Salam Vasant Nayak Shabber Zaveri |
| author_facet | Jalaja Koppa Ramegowda Mohammed Abdul Salam Vasant Nayak Shabber Zaveri |
| author_sort | Jalaja Koppa Ramegowda |
| collection | DOAJ |
| description | Malignant pleural mesothelioma is a rare tumour with survival of 9-17 months after diagnosis. Radical surgical resection by extra-pleural pneumonectomy combined with hyperthermic intrathoracic chemotherapy has shown to improve patient survival and better microscopic tumour control. Anaesthetic management of this procedure is challenging due to the complex pathophysiological changes associated with prolonged duration of surgery, one- lung ventilation, haemodynamic instability due to major blood loss, temperature variations including heat loss during pneumonectomy and rapid rise in temperature during hyperthermic chemotherapy, cardiac arrhythmias due to exposure to heated chemotherapeutics, cisplatin toxicity and acid-base changes. Intra-operative management involves protective ventilation, regulation of temperature and haemodynamics along with prevention of complications associated with ′heated chemotherapeutics′. Thorough pre-operative assessment and preparation, advanced intra-operative monitoring with prompt corrective interventions, will help in improved patient outcome in the immediate post-operative period. We present one such case done for the 1 st time in India. |
| first_indexed | 2024-12-16T13:21:26Z |
| format | Article |
| id | doaj.art-82d3214a159a4b87b41b9ce7a299e312 |
| institution | Directory Open Access Journal |
| issn | 0019-5049 |
| language | English |
| last_indexed | 2024-12-16T13:21:26Z |
| publishDate | 2015-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-82d3214a159a4b87b41b9ce7a299e3122022-12-21T22:30:20ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50492015-01-01591280781010.4103/0019-5049.171574Anaesthetic management of extra-pleural pneumonectomy and hyperthermic intrathoracic chemotherapy procedureJalaja Koppa RamegowdaMohammed Abdul SalamVasant NayakShabber ZaveriMalignant pleural mesothelioma is a rare tumour with survival of 9-17 months after diagnosis. Radical surgical resection by extra-pleural pneumonectomy combined with hyperthermic intrathoracic chemotherapy has shown to improve patient survival and better microscopic tumour control. Anaesthetic management of this procedure is challenging due to the complex pathophysiological changes associated with prolonged duration of surgery, one- lung ventilation, haemodynamic instability due to major blood loss, temperature variations including heat loss during pneumonectomy and rapid rise in temperature during hyperthermic chemotherapy, cardiac arrhythmias due to exposure to heated chemotherapeutics, cisplatin toxicity and acid-base changes. Intra-operative management involves protective ventilation, regulation of temperature and haemodynamics along with prevention of complications associated with ′heated chemotherapeutics′. Thorough pre-operative assessment and preparation, advanced intra-operative monitoring with prompt corrective interventions, will help in improved patient outcome in the immediate post-operative period. We present one such case done for the 1 st time in India.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2015;volume=59;issue=12;spage=807;epage=810;aulast=RamegowdaExtra-pleural pneumonectomyhyperthermic intrathoracic chemotherapymalignant pleural mesotheliomaplethysmographic variability index |
| spellingShingle | Jalaja Koppa Ramegowda Mohammed Abdul Salam Vasant Nayak Shabber Zaveri Anaesthetic management of extra-pleural pneumonectomy and hyperthermic intrathoracic chemotherapy procedure Indian Journal of Anaesthesia Extra-pleural pneumonectomy hyperthermic intrathoracic chemotherapy malignant pleural mesothelioma plethysmographic variability index |
| title | Anaesthetic management of extra-pleural pneumonectomy and hyperthermic intrathoracic chemotherapy procedure |
| title_full | Anaesthetic management of extra-pleural pneumonectomy and hyperthermic intrathoracic chemotherapy procedure |
| title_fullStr | Anaesthetic management of extra-pleural pneumonectomy and hyperthermic intrathoracic chemotherapy procedure |
| title_full_unstemmed | Anaesthetic management of extra-pleural pneumonectomy and hyperthermic intrathoracic chemotherapy procedure |
| title_short | Anaesthetic management of extra-pleural pneumonectomy and hyperthermic intrathoracic chemotherapy procedure |
| title_sort | anaesthetic management of extra pleural pneumonectomy and hyperthermic intrathoracic chemotherapy procedure |
| topic | Extra-pleural pneumonectomy hyperthermic intrathoracic chemotherapy malignant pleural mesothelioma plethysmographic variability index |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2015;volume=59;issue=12;spage=807;epage=810;aulast=Ramegowda |
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