The effect of hyperthermic perfusion chemotherapy on hemodynamics, blood gases and serum tumour necrosis factor (TNF) level's

Abstract

Hyperthermic perfusion cherhotherapy (HPC) is a method which prevents the recurrence of the tumour and has beneficial effects on survival length. During this procedure the effects of extracorporeai circula¬tion, temperature changes and possible increased activity of TNF may cause undesired disturbances in hemo-dynamic variables. Thirteen patients were received HPC with extracorporeai circulation under general anaesthesia. The effect of this therapy on hemodynamic parameters, arterial blood gases, body temperatures and serum TNF levels were investigated. There were no significant changes in' MPAP (mean pulmonary artery pressure), PCWP (pulmonary capil¬lary wedge pressure), CVP (central venous pressure) and heart rate throughout the study. However MAP (mean arterial pressure) decreased significantly at 30th minute of HPC. At this stage both arterial and pump TNF levels increased (11.35+5.15 and 60.38+13.96 respectively). The elevation of TNF with hyperthermia and cytotoxic agents in systemic circulation and its undesired hemodynamic effects can be prevented by hemofiltration. Thus this chemotherapy method can be used safely unless patients are fully monitorized.