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  • 2022-RA-1391-ESGO Perioperative non-invasive advanced hemodynamic monitoring of patients with primary ovarian cancer undergoing multivisceral debulking surgery

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Ovarian cancer
2022-RA-1391-ESGO Perioperative non-invasive advanced hemodynamic monitoring of patients with primary ovarian cancer undergoing multivisceral debulking surgery
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  1. Charlotte Middel1,
  2. Matthias Stetzuhn1,
  3. Nadine Sander1,
  4. Björn Kalkbrenner1,
  5. Timo Tigges2,
  6. Alexandru-Gabriel Pielmus2,
  7. Claudia Spies1,
  8. Klaus Pietzner3,
  9. Michael Klum2,
  10. Clarissa von Haefen1,
  11. Oliver Hunsicker1,
  12. Jalid Sehouli3,
  13. Frank Konietschke4 and
  14. Aarne Feldheiser5,1
  1. 1Department of Anaesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
  2. 2Department of Electronics and Medical Signal Processing, Technical University, Berlin, Germany
  3. 3Department of Gynecology with Center for Oncological Surgery, Campus Virchow Klinikum, Charité – Universitätsmedizin Berlin, Berlin, Germany
  4. 4Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
  5. 5Department of Anaesthesiology and Intensive Care Medicine, Evangelische Kliniken Essen-Mitte, Essen, Germany

Abstract

Introduction/Background Patients undergoing high-risk surgery show an increased haemodynamic instability and have an increased risk of morbidity and mortality. However, the available haemodynamic data concentrate only on the intraoperative period. The aim of this study is to characterize patients hemodynamically throughout the whole intra- and postoperative period non-invasively by thoracic electrical cardiometry (EC) for advanced cardiovascular assessment.

Methodology In a prospective, observational, monocentric study, EC measurements were obtained before surgery, during surgery, and repeatedly throughout the hospital stay in 30 patients with primary ovarian cancer undergoing multivisceral cytoreductive surgery. The inflammatory markers interleukine-6 (IL-6) and inter-cellular-adhesion-molecule-1 (ICAM-1) were analyzed perioperatively. Severe postoperative complications were classified according to the Clavien-Dindo classification and used as a binary grouping criterion (≥3 and <2 or no complications).

Results Throughout the perioperative course, patients showed a longitudinally reduced cardiac index (CI, p<0.0001), while the stroke volume index (SVI, p=0.0528) remained unchanged. Patients suffering from postoperative complications differed over the longitudinal perioperative course in the index of contractility (ICON, p=0.0435) and the systolic time ratio (p=0.0008), without showing differences in CI (p=0.3337). Also, the groups differed during the longitudinal perioperative course in IL-6 (p = 0.0343) and ICAM-1 (p=0.0398).

Conclusion Longitudinally over the perioperative time course CI showed a relevant decrease. Patients with postoperative complications differed from patients without complications in the markers of cardiac function, ICON and STR, as well as showing a lower SVI. These data show haemodynamic alterations during surgery in all patients and especially the association of alterations to complications during the postoperative course. Therefore, they are a first approach to improve noninvasive haemodynamic patient assessments and interdisciplinary perioperative care in the future.

https://doi.org/10.1136/ijgc-2022-ESGO.704

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