Thermal Induction and Temperature Control in the Hyperthermic Antiblastic Regional Perfusion with Extra Corporeal Circulation

Pace, M; Filomena, Alessandro; Galli, Alessandro

doi:10.1007/978-1-4684-5766-7_40

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…The various problems and proposed solutions about the main surgical aspects regarding the vascular isolation, the fundamental criteria for an efficient heat supply and accurate and stable temperature control and measurement, have all been presented in previous works [ 2 , 18 , 21 - 23 ]. The review of our extensive experience was described in a recent report [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

Toxicity and morbility after isolated lower limb perfusion in 242 chemo-hyperthermal treatments for cutaneous melanoma: The experience of the Tuscan Reference Centre

Pace

Gattai²,

Matteini

et al. 2008

J Exp Clin Cancer Res

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Section: Methodsmentioning

confidence: 99%

Toxicity and morbility after isolated lower limb perfusion in 242 chemo-hyperthermal treatments for cutaneous melanoma: The experience of the Tuscan Reference Centre

Pace

Gattai²,

Matteini

et al. 2008

J Exp Clin Cancer Res

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“…An invasive method of regulated WBH should be most successful in achieving and maintaining uniformity of heating. One such method involves heating blood during extracorporeal circulation (ECC-WBH) [16][17][18]. However, the in vivo effects of this manipulation on hemostasis in healthy patients in a controlled setting are poorly characterized.…”

Section: Introductionmentioning

confidence: 99%

“…The canine model was selected for this study because clinical and hematological findings in experimental heat stroke in dogs parallel changes in humans as well as other mammalian species [5]. Heating of venous blood during extracorporeal circulation is an established technique for providing a uniform hyperthermia that is readily controlled [16,18], and the dog is an ideal model for manipulations involving extracorporeal circulation of blood due to the similarities between human and canine cardiovascular and pulmonary physiology. However, extracorporeal blood circuits and bypass systems have produced thrombocytopenia, functional platelet defects, consumption of coagulation factors and fibrinogen, and genesis of fibrin degradation products [19].…”

Section: Introductionmentioning

confidence: 99%

Alterations in hemostasis associated with hyperthermia in a canine model

et al. 2000

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Use of hyperthermia in the treatment of cancer and viral infection has received renewed interest. However, the in vivo relationship between hyperthermia and direct versus indirect effects upon hemostasis are incompletely defined, although we do know that disseminated intravascular coagulation (DIC) is a common sequel to heat stroke. The purpose of the present study was to more precisely define the relationship between hyperthermia and derangements of hemostasis, thereby providing a guideline for the development of safe hyperthermia treatment regimens. The present investigation examined the in vivo effects of high-grade whole-body hyperthermia (WBH) (42.5 degrees C, 90 min) on hemostasis in a canine model. Induction of hyperthermia via extracorporeal circulation of heated blood (ECC-WBH) caused thrombocytopenia, increased plasma fibrin degradation products (FDPs), prolonged clotting times, increased serum liver enzymes, and evidence of spontaneous bleeding. However, when WBH was induced by peritoneal lavage (PL-WBH), transient thrombocytopenia was the only significant alteration. Temporal correlation between hemostatic alterations and elevations in serum alanine aminotransferase (ALT) levels in the ECC-WBH treatment group suggested that liver injury is responsible, at least in part, for the coagulopathy associated with high-grade hyperthermia and that in the absence of liver injury, identical degrees of hyperthermia cause only incidental decreases in platelet numbers.

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Technique and results of regional hyperthermic cytostatic arm perfusion for malignant melanoma

et al. 1997

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Isolated hyperthermic cytostatic limb perfusion has been established as an efficient procedure for the treatment of malignant melanoma of the limbs. However, perfusions of the upper extremities are generally carried out much less frequently than would be expected given the distribution pattern of malignant melanoma and sarcoma. Thus, isolated descriptions of treatment results for perfusion of the upper extremities are not available. Between 1991 and 1994, arm perfusions using melphalan 1.0 mg/kg body weight were given to 14 patients with malignant melanoma, using the standardized method of perfusion described herein. Within an average observation period of 34.9 months (range, 12-65 months), 11 (78.7%) of the 14 patients who had M.D. Anderson stage II-IV melanoma remained free of local recurrence. In fact, 10 (71.6%) of the patients were still alive at the end of the observation period. None of the 14 patients showed any systemic adverse effects, although 1 patient developed a lymphedema 32 months after perfusion and 2 patients showed a postoperative temporary neurologic deficit. These results demonstrate that isolated perfusion of the upper limb with heat and melphalan under standardized conditions remains the treatment of choice for melanoma of the arm, as for melanoma of the leg, without a higher rate of complications.

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Thermal Induction and Temperature Control in the Hyperthermic Antiblastic Regional Perfusion with Extra Corporeal Circulation

Cited by 4 publications

References 4 publications

Toxicity and morbility after isolated lower limb perfusion in 242 chemo-hyperthermal treatments for cutaneous melanoma: The experience of the Tuscan Reference Centre

Toxicity and morbility after isolated lower limb perfusion in 242 chemo-hyperthermal treatments for cutaneous melanoma: The experience of the Tuscan Reference Centre

Alterations in hemostasis associated with hyperthermia in a canine model

Technique and results of regional hyperthermic cytostatic arm perfusion for malignant melanoma

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