Haemodynamic management during hyperthermic intraperitoneal chemotherapy: A systematic review
| Autor: | M Deloménie, Bernard Cholley, Mégane Raineau, Romain Pirracchio, Lucillia Bezu |
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| Rok vydání: | 2019 |
| Předmět: |
MEDLINE
Hemodynamics Context (language use) Cochrane Library Critical Care and Intensive Care Medicine law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Medicine Humans 030212 general & internal medicine Peritoneal Neoplasms business.industry Acute kidney injury 030208 emergency & critical care medicine General Medicine Cytoreduction Surgical Procedures Hyperthermia Induced medicine.disease Combined Modality Therapy Anesthesiology and Pain Medicine Anesthesia Fluid Therapy Hyperthermic intraperitoneal chemotherapy Complication business |
| Zdroj: | Anaesthesia, critical carepain medicine. 39(4) |
| ISSN: | 2352-5568 |
| Popis: | Context Hyperthermic intraperitoneal chemotherapy (HIPEC) is a surgical technique for peritoneal carcinomatosis combining cytoreduction surgery and peritoneal irrigation of cytotoxic agents responsible for haemodynamics and fluid homeostasis alterations. To this day, no guidelines exist concerning intraoperative management. Objectives To review data on haemodynamic monitoring and management of patients undergoing HIPEC and to help design a standardised anaesthetic protocol. Data sources MEDLINE, EMBASE and Cochrane library were searched using the following. Study selection Original articles and case-reports. Letters to editors and reviews were excluded. Data extraction Data on haemodynamic management, morbidity and mortality. Data synthesis Haemodynamic management during HIPEC is highly variable and depends on local protocols. Only one randomised controlled trial evaluated the benefit of goal-directed fluid administration (GDFA). GDFA guided by advanced haemodynamic monitoring resulted in significantly less complication, shorter length of stay and less mortality compared to standard fluid administration. Renal protection protocol did not decrease the risk of acute kidney injury (AKI). Conclusion Our review reveals that fluid administration guided by advanced monitoring seems to be associated with less postoperative morbidity and mortality after HIPEC. Nevertheless, the literature review shows that intraoperative haemodynamic management is highly variable for this surgery. The use of renal protection strategy does not decrease the prevalence of AKI. Further prospective trials comparing different fluid management and haemodynamic monitoring strategies are urgently needed (PROSPERO registration CRD42018115720) |
| Databáze: | OpenAIRE |
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