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当今细胞减灭术和热灌注化疗术后即刻的呼吸并发症:一项观察性研究

Respiratory Complications in the Immediate Postoperative Period after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Nowadays: An Observational Study.

作者信息

Pintado Maria-Consuelo, Oñoro Ana, Beltran Diego, Nevado Emilio

机构信息

Department of Critical Care Unit, Hospital Universitario Principe De Asturias, Alcala De Henares, Community of Madrid, Spain.

出版信息

Indian J Crit Care Med. 2024 Oct;28(10):952-957. doi: 10.5005/jp-journals-10071-24810. Epub 2024 Sep 30.

Abstract

BACKGROUND AND OBJECTIVES

Several respiratory complications have been described after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

MATERIALS AND METHODS

Patients admitted to intensive care unit (ICU) after CRS and HIPEC during 10 years.

DATA RECORDED WERE

Demographic characteristics; severity of illness; complete blood sample; chest radiographs; type of cancer and extension; HIPEC drug and temperature; ICU and hospital stay; and mortality.

RESULTS

Of the 124 patients included, 67 patients (54.0%) presented respiratory complications: 56 (83.6%) acute respiratory failure, 25 (37.3%) pleural effusion, 13 (19.4%) atelectasis, and 3 (4.5%) other; only 1 (3.0%) developed pneumonia. They had higher severity scores at ICU admission. 1 patient required initiation of invasive mechanical ventilation during ICU admission due to pneumonia, and 1 patient needed placement of a pleural chest tube due to symptomatic pleural effusion.Only the need for a high fluid balance during surgery was correlated to the development of respiratory complications on multivariate analysis.Median ICU stay was 5 (4.0-5.0) days. ICU mortality was 0.8.0%.

CONCLUSION

In our study, 54% of patients treated with CRS and HIPEC developed respiratory complications during the postoperative period. However, the majority of these complications were not severe and did not significantly impact mortality rates or hospital stays.

HOW TO CITE THIS ARTICLE

Pintado MC, Oñoro A, Beltran D, Nevado E. Respiratory Complications in the Immediate Postoperative Period after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Nowadays: An Observational Study. Indian J Crit Care Med 2024;28(10):952-957.

摘要

背景与目的

细胞减灭术(CRS)及热灌注化疗(HIPEC)后已有多种呼吸系统并发症的相关报道。

材料与方法

对10年间接受CRS及HIPEC治疗后入住重症监护病房(ICU)的患者进行研究。

记录的数据包括

人口统计学特征;疾病严重程度;全血样本;胸部X光片;癌症类型及分期;HIPEC用药及温度;ICU及住院时间;以及死亡率。

结果

纳入研究的124例患者中,67例(54.0%)出现呼吸系统并发症:56例(83.6%)为急性呼吸衰竭,25例(37.3%)为胸腔积液,13例(19.4%)为肺不张,3例(4.5%)为其他类型;仅1例(3.0%)发生肺炎。这些患者入住ICU时疾病严重程度评分更高。1例患者因肺炎在入住ICU期间需要开始有创机械通气,1例患者因有症状的胸腔积液需要放置胸腔引流管。多因素分析显示,仅手术期间需要较高的液体平衡量与呼吸系统并发症的发生相关。ICU中位住院时间为5(4.0 - 5.0)天。ICU死亡率为0.80%。

结论

在我们的研究中,接受CRS及HIPEC治疗的患者中有54%在术后出现呼吸系统并发症。然而,这些并发症大多并不严重,对死亡率及住院时间没有显著影响。

如何引用本文

Pintado MC, Oñoro A, Beltran D, Nevado E. Respiratory Complications in the Immediate Postoperative Period after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Nowadays: An Observational Study. Indian J Crit Care Med 2024;28(10):952 - 957.

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