ORIGINAL ARTICLES  ANESTHESIA Free access

Minerva Anestesiologica 2006 April;72(4):207-15

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: English, Italian

Non-invasive cardiac monitoring by aortic blood flow determination in patients undergoing hyperthermic intraperitoneal intraoperative chemotherapy

Cafiero T. ¹, Di Iorio C. ¹, Di Minno R. M. ¹, Sivolella G. ¹, Confuorto G. ²

¹ U.O.S.C. di Anestesia, Terapia Intensiva Postoperatoria, C.G.U. ed O.T.I.: A.O.R.N. “A. Cardarelli”, Napoli. 2 U.O.S di Chirurgia Oncologica del Retroperitoneo. A.O.R.N. “A. Cardarelli”, Napoli

Aim. The aim of this study was to evaluate the haemodynamic changes in patients undergoing cytoreductive surgery and intraperitoneal hyperthermic chemotherapy (IPHC) using an echo-Doppler device (Hemosonic 100).
Methods. Experimental design: haemodynamic and cardiac function variables during IPHC, using a closed abdomen technique, were measured with the use of a non-invasive esophageal echo-Doppler monitor. Setting: operating room in an oncologic surgery department in hospital. Fifteen patients, ASA II or III with age ranging from 59 to 66 years were successively studied. All patients were under general anaesthesia with sevoflurane, remifentanil as titrated infusion, and cisatracurium for muscle relaxation. The standard monitoring included ECG, capnometry, invasive measurement of blood pressure and central venous pressure, pulsoximetry, diuresis, esophageal and tympanic temperature. Haemodynamic changes evaluated by an echo-Doppler device were recorded at predetermined times.
Results. A significant reduction in stroke volume (SV) and aortic blood flow (ABF) values was recorded (P<0.05) during the abdominal cavity filling, followed by a significant increase in total systemic vascular resistance values (P<0.05). A significant increase in SV, ABF and left ventricular ejection time was recorded 90 min after the start of IPHC procedure (P<0.05) when the body temperature increased. Peak velocity and acceleration values increased significantly at the same time.
Conclusion. These results suggest that the echo-Doppler device (Hemosonic 100) provided an easy-to-handle, non-invasive and reliable tool to monitor changes in cardiac parameters during IPHC.