This presentation by Dr. Dariush Abtahi discusses the anesthesia management for Hyperthermic Intraperitoneal Chemotherapy (HIPEC), a treatment used after cytoreductive surgery for peritoneal cancers such as pseudomyxoma peritonei, mucinous adenocarcinoma of the appendix, peritoneal mesothelioma, and others. The procedure involves administering heated chemotherapy directly into the peritoneal cavity to enhance drug penetration and effectiveness. Key considerations include managing significant fluid shifts, electrolyte imbalances, acid-base disturbances, and thermal stress during the procedure. Preoperative assessment focuses on evaluating cardiac and pulmonary function, nutritional status, and correcting anemia or hypoalbuminemia. Intraoperatively, standard monitoring, hemodynamic support and lung-protective ventilation strategies are emphasized. Fluid management is critical, with a balance between restrictive and goal-directed therapy to prevent complications like edema or cardiopulmonary impairment. The HIPEC phase can lead to increased abdominal pressure, affecting cardiac output and requiring careful optimization of organ perfusion. Postoperatively, attention is given to pain management, renal function, coagulation profiles, and early mobilization to reduce complications. Special safety precautions are outlined to protect both patients and staff from exposure to chemotherapy agents. Overall, the presentation highlights the multidisciplinary approach required for successful HIPEC administration and postoperative care.
ECG
February 7, 2025
