test 7 hyperthermia

Question 1

Methods of Hyperthermia

Answer 1

• Local hyperthermia
        – External
        – Intraluminal or endocavitary
        – Interstitial
• Regional hyperthermia
        – Deep tissue
        – Regional perfusion
        – Continuous hyperthermic peritoneal perfusion (CHPP)
• Whole-body hyperthermia

Question 2

Peritoneal Carcinosis

Answer 2

• Peritoneal Carcinosis represents the advanced evolutive stage of several tumors that develop into abdominal organs, such as colon, ovary, appendix, stomach, pancreas and liver.

Question 3

Once the Peritoneal Carcinosis increases

Answer 3

• tumor cells reach and affect the membrane covering the same organs (visceral peritoneum).
• Once this “barrier” has been crossed, affected cells are able to move into the abdominal cavity, carried by peritoneal fluid.
• The tumor cells present into the liquid can die or survive feeding on substances contained in the same liquid. These cells tend to accumulate in those points of greater liquid reabsorption, creating agglomerates that grow more and more, spreading into the whole abdomen giving rise to the carcinosis

Question 4

Modes of perfusion (techniques for Peritoneal Carcinosis treatment)

Answer 4

• Open or “Coliseum” Technique
• Closed Technique
• Percutaneous Technique

Question 5

HIPEC Protocol

Answer 5

• Patient drifts down to 35o during CRS
• 1 L/min (1/4” tubing)
• 1 1/2 hour circulation at 42o
• Warms to 38.8 at most

Question 6

Guidelines for Safe Administration of HIPEC

Answer 6

• Avoid use of any non-disposable fabric cloth
• After cryoreduction; all staff not directly involved should leave OR
• Rigid containers, leak proof for biologic hazardous waste should be used and labeled “cytotoxic agents”; should not be > ½ full
• Protective barrier garments, shoe covers, nonpermeable powderless gloves (double gloved)
• Gloves changed every 30 minutes
• Body fluids considered contaminated for 48 hours
• Smoke evacuator used continuously under plastic sheet during perfusion
• Every effort used to avoid spills
• If direct contact made, contaminated clothing removed; affected skin washed immediately with additive free soap, no dyes of perfumes
– Area washed three (3) times
• If eye is affected, flood with water or isotonic saline for five (5) minutes
• Instruments washed three (3) times with water and pur soap