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减瘤手术联合腹腔内热灌注化疗(CRS-HIPEC)后出现的体温反跳过低及术后即刻心脏骤停:两例报告并文献复习

Rebound hypothermia after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) and cardiac arrest in immediate postoperative period: a report of two cases and review of literature.

作者信息

Solanki Sohan Lal, Jhingan Mrida A K, Saklani Avanish P

机构信息

Department of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.

Gastro-Intestinal Services, Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.

出版信息

Pleura Peritoneum. 2020 Aug 27;5(3):20200126. doi: 10.1515/pp-2020-0126. eCollection 2020 Sep.

Abstract

OBJECTIVES

Cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy (CRS-HIPEC) for peritoneal malignancies are complex surgeries marked with hemodynamic perturbations, temperature fluctuations, blood loss and metabolic disturbances in the intra-operative and post-operative period. In this report, we highlighted perioperative factors which may have led to cardiac arrest in immediate postoperative period and subsequent successful resuscitation in two patients with high volume peritoneal cancers who underwent CRS-HIPEC.

CASE PRESENTATION

Both patients had a similar clinical course, characterized by massive blood and fluid loss, metabolic derangement, hemodynamic instability, long duration of surgery, post HIPEC rebound hypothermia and hypokalemia which need to be anticipated.

CONCLUSIONS

We reviewed the literature related to postoperative hypothermia and other major complications after CRS-HIPEC and correlated the available literature with our findings.

摘要

目的

针对腹膜恶性肿瘤的细胞减灭术及腹腔热灌注化疗(CRS-HIPEC)是复杂的手术,在术中和术后会出现血流动力学紊乱、体温波动、失血及代谢紊乱。在本报告中,我们着重介绍了可能导致两名接受CRS-HIPEC的大量腹膜癌患者术后即刻心脏骤停及随后成功复苏的围手术期因素。

病例介绍

两名患者的临床过程相似,其特点是大量失血和体液丢失、代谢紊乱、血流动力学不稳定、手术时间长、热灌注化疗后体温反跳性降低及低钾血症,这些情况均需提前预料到。

结论

我们回顾了与CRS-HIPEC术后体温过低及其他主要并发症相关的文献,并将现有文献与我们的研究结果进行了对比。

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