This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Vertrees, R. A Articles by Chernin, J. M Search for Related Content PubMed PubMed Citation Articles by Vertrees, R. A Articles by Chernin, J. M Social Bookmarking                         What's this?

Veno-venous perfusion-induced systemic hyperthermia: case report with perfusion considerations

Department of Surgery, The University of Texas Medical Branch, Galveston, Texas, rvertree{at}utmb.edu

Joseph B Zwischenberger

Department of Surgery, The University of Texas Medical Branch, Galveston, Texas

Lee C Woodson

Department of Anesthesiology, The University of Texas Medical Branch, Galveston, Texas

Eric A Bedell

Department of Anesthesiology, The University of Texas Medical Branch, Galveston, Texas

Donald J Deyo

Department of Anesthesiology, The University of Texas Medical Branch, Galveston, Texas

Jill M Chernin

Department of Critical Care Nursing, The University of Texas Medical Branch, Galveston, Texas

Cancer cells are more susceptible to destruction by heat than are their normal counterparts. However, optimization of this hyperthermic susceptibility for selective cancer cell kill has been difficult to define and technically difficult to achieve. A whole-body hyperthermic technique - veno-venous perfusion-induced systemic hyperthermia (VV-PISH) was designed in in vitro and in swine experiments to achieve selective hyperthermic cancer cell destruction. In this case report, VV-PISH is studied for its safety and therapeutic efficiency in a Food and Drug Administration (FDA) approved phase-I study, where hyperthermia is used to treat advanced (Stage III B or IV) lung cancer.

VV-PISH, utilizing the ThermoChem^TM HT system in an extracorporeal circuit, was used to induce hyperthermia to 42.5°C sustained for 120 min. Cooling returned the body temperature to 37°C. After completion of the treatment, the patient was transferred to the intensive care unit on a ventilator, norepinephrine and diuretics. The patient remained somnolent for 36 h, developed pulmonary congestion requiring an additional 48 h before extubation, was transferred to the intermediate unit on day 4 and discharged in good condition on day 8. He did experience hyperthermia-related shrinkage of his lung cancer; however, he succumbed 270 days after this treatment from further progression of this disease.

Hyperthermia is not a benign therapy; management techniques have been developed that have ameliorated many of the problems associated with extremely high temperatures, but pathophysiology still exists. Using these techniques, VV-PISH can be safety implemented, albeit not without temporary sequelae and further hospitalization.

Perfusion, Vol. 16, No. 3, 243-248 (2001)
DOI: 10.1177/026765910101600310


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?