RT Journal Article
SR Electronic
T1 2022-RA-1347-ESGO The impact of the induction of anaesthesia and the opening of the abdominal cavity on haemodynamic parameters in cytoreductive debulking surgery
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP A326
OP A327
DO 10.1136/ijgc-2022-ESGO.695
VO 32
IS Suppl 2
A1 Charlotte Middel
A1 Matthias Stetzuhn
A1 Nadine Sander
A1 Björn Kalkbrenner
A1 Timo Tigges
A1 Alexandru-Gabriel Pielmus
A1 Claudia Spies
A1 Klaus Pietzner
A1 Michael Klum
A1 Clarissa von Haefen
A1 Oliver Hunsicker
A1 Jalid Sehouli
A1 Frank Konietschke
A1 Aarne Feldheiser
YR 2022
UL http://ijgc.bmj.com/content/32/Suppl_2/A326.2.abstract
AB Introduction/Background High-risk surgery frequently is associated with haemodynamic instability leading to the administration of high amounts of intravenous fluids and catecholamines to stabilize cardiovascular function. The haemodynamic instability is commonly attributed to the inflammatory response related to surgical trauma. In this study, we investigated also, how the induction of anaesthesia and the opening of the abdominal cavity impact haemodynamics.Methodology In a prospective, observational, monocentric study, haemodynamic measurements were obtained by the non-invasive methodology of thoracic electrical cardiometry (EC) in 29 patients with primary ovarian cancer undergoing multivisceral cytoreductive surgery. The change of haemodynamic parameters was analyzed from the day prior to surgery to the first intraoperative measurement by non-parametric longitudinal data analysis in a two-factorial experiment (dependent factor time).Results Median age of patients was 59 [25-quartile 50; 75-quartile 61] years. 8 (28%) patients had a diagnosis of arterial hypertension, otherwise, no cardiovascular diseases were shown. The FIGO stages were in 22 (75%) patients above stage IIIc and 9 (31%) patients had more than 500 ml of ascites.The relative change from the baseline to the first intraoperative timepoint showed a reduced heart rate (HR, median -19 [25-quartile -26%; 75-quartile -10%]%, p<0.0001), stroke volume index (SVI, -9.5 [-15.3;3.2]%, p=0.0038), cardiac index (CI, -24.5 [-32;-13]%, p<0.0001) and the inotropic marker index of contractility (ICON, -17.5 [-35.3;-0.8]%, p<0.0001).Abstract 2022-RA-1347-ESGO Figure 1 Conclusion Substantial changes in HR, SVI, CI, and ICON occurred from the day prior to surgery to the first intraoperative measurement, indicating that patients without relevant cardiovascular morbidity showed reduced cardiocirculatory flow and cardiac function. Furthermore, these data indicate that pharmacological modulation might optimize haemodynamic care during high-risk gynaecological surgery.