Higher flow rates improve heating during hyperthermic intraperitoneal chemoperfusion.

Autor: Furman MJ; Division of Surgical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts., Picotte RJ, Wante MJ, Rajeshkumar BR, Whalen GF, Lambert LA
Jazyk: angličtina
Zdroj: Journal of surgical oncology [J Surg Oncol] 2014 Dec; Vol. 110 (8), pp. 970-5. Date of Electronic Publication: 2014 Aug 29.
DOI: 10.1002/jso.23776
Abstrakt: Background/objectives: Heated intraperitoneal chemotherapy (HIPEC) kills cancer cells via thermal injury and improved chemotherapeutic cytotoxicity. We hypothesize that higher HIPEC flow rates improve peritoneal heating and HIPEC efficacy.
Methods: (1) A HIPEC-model (30.8 L cooler with attached extracorporeal pump) was filled with 37°C water containing a suspended 1 L saline bag (SB) wrapped in a cooling sleeve, creating a constant heat sink. (2) HIPECs were performed in a swine model. Inflow, outflow, and peritoneal temperatures were monitored as flow rates varied. (3) Flow rates and temperatures during 20 HIPECs were reviewed.
Results: Higher flow rates decreased time required to increase water bath (WB) and SB temperature to 43°C. With a constant heat sink, the minimum flow rate required to reach 43°C in the WB was 1.75 L/min. Higher flow rates lead to greater temperature gradients between the WB and SB. In the swine model, the minimum flow rate required to reach 43°C outflow was 2.5-3.0 L/min. Higher flows led to more rapid heating of the peritoneum and greater peritoneal/outflow temperature gradients. Increased flow during clinical HIPEC suggested improved peritoneal heating with lower average visceral temperatures.
Conclusions: There is a minimum flow rate required to reach goal temperature during HIPEC. Flow rate is an important variable in achieving and maintaining goal temperatures during HIPEC.
(© 2014 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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