Cardiovascular changes during continuous hyperthermic peritoneal perfusion.

Abstract

Changes in blood temperature, hemodynamics, and oxygen transport were evaluated in 11 patients during continuous hyperthermic peritoneal perfusion (CHPP), a technique in which the peritoneal cavity is perfused continuously with heated solution to treat intraperitoneal cancer. CHPP was undertaken 46.8 min after the resection of cancer. Blood temperature, measured with a thermistor of a pulmonary artery catheter, reached 39.2 degrees C. Heart rate increased to 100.7 +/- 21.4 bpm (mean +/- SD) and the cardiac index to 4.61 +/- 0.80 L.min-1.m-2. Mean arterial pressure decreased to 75.5 +/- 10.8 mm Hg and systemic vascular resistance index to 1239 +/- 394 dynes.s.cm-5.m2. Oxygen consumption greatly increased to 139.1 +/- 35.2 mL.min-1.m-2, concurrently with a smaller increase in oxygen delivery to 619.7 +/- 83.7 mL.min-1.m-2 and a slight increase in oxygen extraction. Pulmonary oxygenation capacity was also disturbed. Although these cardiovascular changes were mainly due to systemic hyperthermia, other changes may be caused by splanchnic heating, abdominal distention, and pharmacologic action of methoxamine, propranolol, diltiazem, and fentanyl.