Hyperthermia-induced pulmonary edema

Mustafa, K. Y.; Selig, William M.; Burhop, Kenneth E.; Minnear, Fred L.; Malik, Asrar B.

doi:10.1152/jappl.1986.60.6.1980

Cited by 13 publications

(6 citation statements)

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“…The development of myocardial ischemia is a possible complication especially for patients with existing coronary artery disease. Hyperthermia can also lead to pulmonary edema and ventilator-induced acute lung injury [29,30]. In addition it may contribute to development of neurocognitive dysfunction, which is often described during the rewarming process after cardiopulmonary bypass for cardiac surgery [31].…”

Section: Discussionmentioning

confidence: 99%

Anaesthetic management of cytoreductive surgery followed by hyperthermic intrathoracic chemotherapy perfusion

Kerscher

Ried

Hofmann

et al. 2014

J Cardiothorac Surg

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BackgroundMacroscopic cytoreductive surgery and hyperthermic intrathoracic chemotherapy perfusion (HITHOC) is a new multimodal approach for selected patients with primary and secondary pleural tumors, which may provide the patient with better local tumor control and increased overall survival rate.MethodsWe present a single-center study including 20 patients undergoing cytoreductive surgery and HITHOC between September 2008 and April 2013 at the University Medical Center Regensburg, Germany. Objective of the study was to describe the perioperative, anaesthetic management with special respect to pain and complication management.ResultsAnaesthesia during this procedure is characterized by increased intrathoracic airway and central venous pressure, hemodynamic alterations and the risk of systemic hypo- and hyperthermia. Securing an adequate intravascular volume is one of the primary goals to prevent decreased cardiac output as well as pulmonary edema. Transfusion of packed red blood cells (PRBC) was necessary in seven of 20 (35%) patients. Only two patients (10%) showed an impairment of coagulation in postoperative laboratory analysis. Perioperative forced diuresis is recommended to prevent postoperative renal insufficiency. Supplementary thoracic epidural analgesia in 13 patients (65%) showed a significant reduction of post-operative pain compared with peroral administration of opioid and non-opioid analgesics.ConclusionThis article summarizes important experiences of the anaesthesiological and intensive care management in patients undergoing HITHOC.

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Section: Discussionmentioning

confidence: 99%

Anaesthetic management of cytoreductive surgery followed by hyperthermic intrathoracic chemotherapy perfusion

Kerscher

Ried

Hofmann

et al. 2014

J Cardiothorac Surg

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“…The efficacy of hyperthermia in the treatment of patients with malignant neoplasms has been demonstrated in vitro16, 17 and in vivo 18. Its use in the pleural space is limited to 43 °C due to an increased risk of pulmonary edema above this temperature 19. Combining hyperthermia with antitumoral drugs may produce an additive effect 20.…”

Section: Discussionmentioning

confidence: 99%

Hyperthermic pleural perfusion with cisplatin

Yellin

Simansky

Paley

et al. 2001

Cancer

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BACKGROUND The preferred treatment for patients with pleural tumors or tumors with pleural extension has not been determined. Systemic and local modalities were studied, including intrapleural chemotherapy and hyperthermia, which mainly have been investigated separately. The objective of this study was to investigate the feasibility, toxicity and early results of a multimodality treatment consisting of surgery, chemotherapy, and hyperthermia in one session for the treatment of patients with pleural malignancies. METHODS From November 1994 to September 1998, 26 patients (7 patients with mesothelioma, 11 patients with thymic neoplasms, and 8 patients with other tumors) underwent intraoperative hyperthermic pleural perfusion (HPP). Perfusion was performed with a roller pump and a heat exchanger. Cisplatin was added when the temperature stabilized to a mean of 40.8 °C (range, 40.2–41.5 °C). Dosages of cisplatin used were 60 mg in 2 patients, 100 mg in 2 patients, 120 mg in 1 patient, 150 mg in 18 patients, and 200 mg in 3 patients. The patients underwent the following associated surgeries: extended extrapleural pneumonectomy in 8 patients, resection of tumor without pleurectomy in 4 patients, resection of tumors with pleurectomy in 10 patients, and exploration and HPP only in 4 patients (thoracotomy in 2 patients and video‐assisted thoracoscopy in 2 patients). RESULTS There were no technical problems during the perfusion period. The systemic temperature rose to a maximum of 38 °C. There was no renal or hematologic toxicity, except in one patient who experienced thrombocytopenia. One patient died from complications related to a technical error. Eight patients had complications; the most bothersome were in four patients with empyema (early in two patients and late in two patients). The median postoperative hospital stay was 7 days (range, 2–50 days). Ten patients were alive 28–69 months after surgery. The overall 1‐year, 2‐year, and 3‐year survival rates were 72%, 65%, and 44%, respectively. Complete ipsilateral pleuropulmonary control was achieved in 17 patients (9 patients who are alive and 8 patients who have died). CONCLUSIONS Intraoperative HPP with cisplatin is feasible, easy to perform, and relatively safe. This method may offer excellent local control for patients with pleural tumors. Cancer 2001;92:2197–203. © 2001 American Cancer Society.

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“…In addition to one death due to unrelated heart failure, there was no evidence of metastases to distant site or local recurrence in the other three patients. The temperature between 42°C and 43°C is considered to be efficacious in the treatment of patients with malignant neoplasms, but produces little risk of pulmonary edema 17,18. In our study, our patients’ core temperature varied from 36.3°C to 39.3°C and pulse from 59 beats/min to 126 beats/min.…”

Section: Discussionmentioning

confidence: 69%

Cytoreductive surgery combined with hyperthermic intrapleural chemotherapy to treat thymoma or thymic carcinoma with pleural dissemination

Yu¹,

Yun²,

Ma³

et al. 2013

OTT

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BackgroundThe treatment of thymoma or thymic carcinoma with pleural dissemination remains controversial due to the unpredictable natural history of this tumor. Our study discusses the combination of cytoreductive surgery with hyperthermic intrapleural chemotherapy to treat thymoma or thymic carcinoma with pleural dissemination.MethodsFrom February 2008 to January 2010, there were four patients with pleural thymoma metastases undergoing cytoreductive surgery and intrathoracic hyperthermic perfusion with chemotherapy at our department. After video-assisted thoracoscopic surgery, the hyperthermic perfusion system was set up for hyperthermic intrapleural chemotherapy. The thoracic cavity was perfused at a speed of approximately 1.8–2.3 L/min with 0.9% normal saline. The intrathoracic temperature remained between 42°C and 43°C. The perfusion process lasted for 2 hours.ResultsThere were no perioperative deaths. During the hyperthermic perfusion, the patient’s core temperature varied from 36.3°C and 39.3°C and pulse varied from 59 beats/min and 126 beats/min. Intraoperative sinus tachycardia occurred in two elderly patients. No hematologic toxicity and nephrotoxicity was observed within 1 week after surgery. Postoperative pneumonia occurred in one elderly patient. Patients were followed up for 1–4 years. One elderly patient died of heart failure 1 year after surgery. There were no patients with local recurrence or metastases to distant sites.ConclusionsCytoreductive surgery and intrathoracic hyperthermic perfusion with chemotherapy may be effective in treating thymoma or thymic carcinoma with pleural dissemination and has an encouraging impact on the patients’ long-term survival.

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Hyperthermia-induced pulmonary edema

Cited by 13 publications

References 0 publications

Anaesthetic management of cytoreductive surgery followed by hyperthermic intrathoracic chemotherapy perfusion

Anaesthetic management of cytoreductive surgery followed by hyperthermic intrathoracic chemotherapy perfusion

Hyperthermic pleural perfusion with cisplatin

Cytoreductive surgery combined with hyperthermic intrapleural chemotherapy to treat thymoma or thymic carcinoma with pleural dissemination

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