anaesthetic management of extra-pleural pneumonectomy and hyperthermic intrathoracic chemotherapy procedure

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ID: 179259
2015
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Ranked #101 of 138 articles by views in Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association

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Abstract
Malignant pleural mesothelioma is a rare tumour with survival of 9-17 months after diagnosis. Radical surgical resection by extra-pleural pneumonectomy combined with hyperthermic intrathoracic chemotherapy has shown to improve patient survival and better microscopic tumour control. Anaesthetic management of this procedure is challenging due to the complex pathophysiological changes associated with prolonged duration of surgery, one- lung ventilation, haemodynamic instability due to major blood loss, temperature variations including heat loss during pneumonectomy and rapid rise in temperature during hyperthermic chemotherapy, cardiac arrhythmias due to exposure to heated chemotherapeutics, cisplatin toxicity and acid-base changes. Intra-operative management involves protective ventilation, regulation of temperature and haemodynamics along with prevention of complications associated with ′heated chemotherapeutics′. Thorough pre-operative assessment and preparation, advanced intra-operative monitoring with prompt corrective interventions, will help in improved patient outcome in the immediate post-operative period. We present one such case done for the 1 st time in India.
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ramegowda2015indiananaesthetic Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Jalaja Koppa Ramegowda;Mohammed Abdul Salam;Vasant Nayak;Shabber Zaveri
Journal Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association
Year 2015
DOI
10.4103/0019-5049.171574
URL
http://www.ijaweb.org/article.asp?issn=0019-5049;year=2015;volume=59;issue=12;spage=807;epage=810;aulast=Ramegowda
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