Intraoperative fluid restriction in hyperthermic intraperitoneal chemotherapy

Tariq Almerey, Emmanuel M. Gabriel, Klaus D Torp, Sanjay P. Bagaria

Research output: Contribution to journalArticle

Abstract

Background: Multiple studies highlight the importance of liberal fluid administration in cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). Over-resuscitation can delay recovery and wound healing. We report an intraoperative protocol that restricts fluid administration and minimizes morbidity. Materials and Methods: Retrospective analysis of 35 patients that underwent CRS-HIPEC for curative intent under fluid restriction protocol from June 2015 to July 2017 was performed. Protocol consists of continuous infusion of vasopressin 0.02 units/h and maintaining urine output at 0.5 mL/kg/h via crystalloid and colloid. Endpoint was Clavien-Dindo ≥3 events within 30 d of CRS-HIPEC. Results: Median age was 56 y; 71% were female. Malignancies treated: appendix (49%), colon (31%), and other (20%). Median peritoneal cancer index was 15, complete cytoreduction was achieved in 91% of patients. Median time for return of bowel function was 5 d, median length of hospital stay was 7 d. There were 28 bowel anastomoses. Median intraoperative crystalloid, colloid, and packed red blood cells were (1900, 1500, and 700 mL), respectively. Clavien-Dindo grade 3-4 events occurred in five patients. There were no deaths 30 d after surgery. Conclusions: A fluid restriction protocol appears to be safe and feasible in the setting of CRS-HIPEC for curative intent.

Original languageEnglish (US)
Pages (from-to)77-82
Number of pages6
JournalJournal of Surgical Research
Volume231
DOIs
StatePublished - Nov 1 2018

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Drug Therapy
Colloids
Length of Stay
Appendix
Vasopressins
Resuscitation
Wound Healing
Neoplasms
Colon
Erythrocytes
Urine
Morbidity
crystalloid solutions

Keywords

  • Colorectal
  • Morbidity
  • Regional therapy

ASJC Scopus subject areas

  • Surgery

Cite this

Intraoperative fluid restriction in hyperthermic intraperitoneal chemotherapy. / Almerey, Tariq; Gabriel, Emmanuel M.; Torp, Klaus D; Bagaria, Sanjay P.

In: Journal of Surgical Research, Vol. 231, 01.11.2018, p. 77-82.

Research output: Contribution to journalArticle

Almerey, Tariq ; Gabriel, Emmanuel M. ; Torp, Klaus D ; Bagaria, Sanjay P. / Intraoperative fluid restriction in hyperthermic intraperitoneal chemotherapy. In: Journal of Surgical Research. 2018 ; Vol. 231. pp. 77-82.
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