Post-operative critical care management of patients undergoing cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC)
<p>Abstract</p> <p>Background</p> <p>Cytoreductive surgery (CRS) and Heated Intraperitoneal Chemotherapy (HIPEC) results in a number of physiological changes with effects on the cardiovascular system, oxygen consumption and coagulation. The Critical Care interventions r...
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| Format: | Article |
| Language: | English |
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BMC
2011-12-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | http://www.wjso.com/content/9/1/169 |
| _version_ | 1811317660243197952 |
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| author | Cooksley Timothy J Haji-Michael Philip |
| author_facet | Cooksley Timothy J Haji-Michael Philip |
| author_sort | Cooksley Timothy J |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Cytoreductive surgery (CRS) and Heated Intraperitoneal Chemotherapy (HIPEC) results in a number of physiological changes with effects on the cardiovascular system, oxygen consumption and coagulation. The Critical Care interventions required by this cohort of patients have not yet been quantified.</p> <p>Methods</p> <p>This retrospective audit examines the experience of a Specialist Tertiary Centre in England over an 18 month period (January 2009-June 2010) during which 69 patients underwent CRS and HIPEC. All patients were extubated in the operating theatre and transferred to the Critical Care Unit (CCU) for initial post-operative management.</p> <p>Results</p> <p>Patients needed to remain on the CCU for 2.4 days (0.8-7.8). There were no 30 day mortalities. The majority of patients (70.1%) did not require post-operative organ support. 2 patients who developed pneumonia post-operatively required respiratory support. 18 (26.1%) patients required vasopressor support with norepinephrine with a mean duration of 13.94 hours (5-51 hours) and mean dose of 0.04 mcg/kg/min. Post-operative coagulopathy peaked at 24 hours. A significant drop in serum albumin was observed.</p> <p>Conclusion</p> <p>The degree of organ support required post-operatively is minimal. Early extubation is efficacious with the aid of epidural analgesia. Critical Care monitoring for 48 hours is desirable in view of the post-operative challenges.</p> |
| first_indexed | 2024-04-13T12:12:09Z |
| format | Article |
| id | doaj.art-eb42eb5ae8cb42c2b66e628a283262ed |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-04-13T12:12:09Z |
| publishDate | 2011-12-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-eb42eb5ae8cb42c2b66e628a283262ed2022-12-22T02:47:27ZengBMCWorld Journal of Surgical Oncology1477-78192011-12-019116910.1186/1477-7819-9-169Post-operative critical care management of patients undergoing cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC)Cooksley Timothy JHaji-Michael Philip<p>Abstract</p> <p>Background</p> <p>Cytoreductive surgery (CRS) and Heated Intraperitoneal Chemotherapy (HIPEC) results in a number of physiological changes with effects on the cardiovascular system, oxygen consumption and coagulation. The Critical Care interventions required by this cohort of patients have not yet been quantified.</p> <p>Methods</p> <p>This retrospective audit examines the experience of a Specialist Tertiary Centre in England over an 18 month period (January 2009-June 2010) during which 69 patients underwent CRS and HIPEC. All patients were extubated in the operating theatre and transferred to the Critical Care Unit (CCU) for initial post-operative management.</p> <p>Results</p> <p>Patients needed to remain on the CCU for 2.4 days (0.8-7.8). There were no 30 day mortalities. The majority of patients (70.1%) did not require post-operative organ support. 2 patients who developed pneumonia post-operatively required respiratory support. 18 (26.1%) patients required vasopressor support with norepinephrine with a mean duration of 13.94 hours (5-51 hours) and mean dose of 0.04 mcg/kg/min. Post-operative coagulopathy peaked at 24 hours. A significant drop in serum albumin was observed.</p> <p>Conclusion</p> <p>The degree of organ support required post-operatively is minimal. Early extubation is efficacious with the aid of epidural analgesia. Critical Care monitoring for 48 hours is desirable in view of the post-operative challenges.</p>http://www.wjso.com/content/9/1/169Critical CarePseudomyxoma peritoneiHIPECCytoreductive surgery |
| spellingShingle | Cooksley Timothy J Haji-Michael Philip Post-operative critical care management of patients undergoing cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC) World Journal of Surgical Oncology Critical Care Pseudomyxoma peritonei HIPEC Cytoreductive surgery |
| title | Post-operative critical care management of patients undergoing cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC) |
| title_full | Post-operative critical care management of patients undergoing cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC) |
| title_fullStr | Post-operative critical care management of patients undergoing cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC) |
| title_full_unstemmed | Post-operative critical care management of patients undergoing cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC) |
| title_short | Post-operative critical care management of patients undergoing cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC) |
| title_sort | post operative critical care management of patients undergoing cytoreductive surgery and heated intraperitoneal chemotherapy hipec |
| topic | Critical Care Pseudomyxoma peritonei HIPEC Cytoreductive surgery |
| url | http://www.wjso.com/content/9/1/169 |
| work_keys_str_mv | AT cooksleytimothyj postoperativecriticalcaremanagementofpatientsundergoingcytoreductivesurgeryandheatedintraperitonealchemotherapyhipec AT hajimichaelphilip postoperativecriticalcaremanagementofpatientsundergoingcytoreductivesurgeryandheatedintraperitonealchemotherapyhipec |