Perioperative management of hyperthermic intraperitoneal chemotherapy
Por:
Carrillo-Esper R., Nava-López J.A., Romero-Sierra G., Cáñez-Jiménez C.
Publicada:
1 ene 2014
Categoría:
Anesthesiology and Pain Medicine
Resumen:
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) has become the standard treatment for patients with tumors of the peritoneal surface. Completion of this combined procedure can last up to more than 13 hours during which alterations as hydroelectrolyte imbalance, hypovolemia, coagulopathy, changes in temperature and metabolism, as well as changes in lung function are presented. The technique for the administration of intraperitoneal therapy has its own risks, mainly cardiovascular, especially with the closed technique. The perioperative management should be individualized according to the needs of each patient and use the monitoring to adapt and optimize the mechanical ventilation, fl uid replacement, coagulation and hemodynamic status. The use of combined general and regional anesthesia improves the prognosis of patients, however not all are candidates for neuraxial blockade. The aim of this review is that the anesthesiologist knows the process of HIPEC and alterations that may occur in the perioperative period to prevent and treat them in a timely manner. © 2014, SAREM Sociedad Argentina para el Estudio de los Mamiferos. All rights reserved.
Filiaciones:
Carrillo-Esper R.:
Academia Nacional de Medicina, Academia Mexicana de Cirugía, Unidad de Terapia Intensiva de la Fundación Clínica Médica Sur, Mexico
Nava-López J.A.:
Anestesiología Hospital General de México, Medicina del Enfermo Adulto en Estado Crítico Fundación Clínica Médica Sur, Mexico
Romero-Sierra G.:
Anestesiología Hospital General Naval de Alta Especialidad, Mexico
Cáñez-Jiménez C.:
Anestesiología Hospital General Naval de Alta Especialidad, Mexico
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