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Open Access 01-12-2013 | Research article

Anesthesia management of patients undergoing hyperthermic isolated limb perfusion with melphalan for melanoma treatment: an analysis of 17 cases

Authors: Heiner Ruschulte, Serena Shi, William W Tseng, Kerstin Kolodzie, Philip C Crawford, Darren B Schneider, Mohammed Kashani-Sabet, David Minor, Christian Apfel, Stanley PL Leong

Published in: BMC Anesthesiology | Issue 1/2013

Abstract

Background

Hyperthermic isolated limb perfusion (HILP) is used for patients with intractable or extensive in-transit metastatic melanoma of the limb to deliver high concentrations of cytotoxic agents to the affected limb and offers a treatment option in a disease stage with a poor prognosis when no treatment is given.

Methods

In a retrospective chart review of 17 cases, we studied the anesthetic and hemodynamic changes during HILP and its management.

Results

HILP was well tolerated except in one case that is described herein. We present summary data of all cases undergoing upper and lower limb perfusion, discuss our current clinical practice of preoperative, perioperative and intraoperative patient care including the management of HILP circuit.

Conclusion

HILP is a challenging procedure, and requires a team effort including the surgical team, anesthesia care providers, perfusionists and nurses. Intraoperatively, invasive hemodynamic and metabolic monitoring is indispensable to manage significant hemodynamic and metabolic changes due to fluid shifts and release of cytokines.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2253/13/15/prepub

Title: Anesthesia management of patients undergoing hyperthermic isolated limb perfusion with melphalan for melanoma treatment: an analysis of 17 cases
Authors: Heiner Ruschulte
Serena Shi
William W Tseng
Kerstin Kolodzie
Philip C Crawford
Darren B Schneider
Mohammed Kashani-Sabet
David Minor
Christian Apfel
Stanley PL Leong
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: BMC Anesthesiology / Issue 1/2013
Electronic ISSN: 1471-2253
DOI: https://doi.org/10.1186/1471-2253-13-15

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Anesthesia management of patients undergoing hyperthermic isolated limb perfusion with melphalan for melanoma treatment: an analysis of 17 cases

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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