Temperature Monitoring in HIPEC: A Study

Hyperthermic intraperitoneal chemotherapy (HIPEC) is a special kind of treatment used for patients with cancer that has spread in the abdominal area. Instead of just using regular chemotherapy, HIPEC delivers heated chemotherapy directly into the body's abdominal cavity. This approach has shown patients can live longer when compared to traditional methods that only help with symptoms.

#The Role of Temperature in HIPEC

Temperature plays a big part in how the body reacts during HIPEC. When the body gets heated, the heart starts to beat faster, and there can be changes in the levels of gases in the body, like carbon dioxide. This increase in temperature can also lead to some changes in how our bodies work, which is why medical professionals pay attention to it.

Interestingly, research has found that even a slight rise in body temperature can mess with memory. When healthy people were heated up to just below 39 °C (about 102.2 °F), they struggled to remember things compared to when their bodies were at normal temperature. It seems that the brain is quite sensitive to temperature changes!

#How Our Bodies Manage Temperature

Our bodies are not always at the same temperature all over. There can be a difference of a few degrees between the core (center) temperature and the surface temperature. Normally, when the outside temperature changes, our bodies have tricks up their sleeves to keep things balanced. However, during quick changes, like cooling off or warming up, this balance can shift.

During major Surgeries that involve removing a lot of cancer tissue, patients usually cool down. But once the heated chemotherapy is introduced, Temperatures can shoot back up. This sudden change means careful temperature monitoring is crucial to keep everything under control.

#Monitoring Temperature: Why It Matters

Accurate temperature monitoring throughout HIPEC is essential. There are several ways to check temperature. The best and most accurate way is through a special tube placed in the pulmonary artery. However, this method can be quite invasive. This is why doctors sometimes use other methods like probes in the esophagus or nasopharynx (the area behind the nose), as well as skin-based thermometers.

In our study, we wanted to find out how effective the Nasopharyngeal temperature monitoring was compared to these other methods during HIPEC with additional surgery to remove cancer.

#Study Setup

Before starting the study, we got the green light from the hospital’s ethics committee. We also obtained written consent from all patients to participate. Between July 2019 and December 2022, we gathered data from patients who had this surgery along with HIPEC.

We included 41 patients who met specific conditions and removed others who weren't suitable for these temperature monitoring techniques. All patients received the same kind of anesthesia during their procedures.

#How We Measured Temperature

During the surgeries, we measured temperatures in different areas. The skin temperature was assessed on the forehead with a special sensor, while the nasopharyngeal temperature was checked with a probe. Another measurement came from an esophageal probe that was placed in the esophagus right after patients were put under anesthesia.

All these temperature readings were taken every five minutes throughout the surgery. We then looked at the differences in the temperature readings between these areas to see how close they were.

#Analyzing the Results

To see how well the nasopharyngeal readings matched with the other methods, we ran some clever analyses. We wanted to find out if the differences were acceptable. We set a limit of half a degree Celsius (0.5 °C) as the maximum acceptable difference.

In our findings, the average difference between nasopharyngeal temperature and forehead readings was quite small, about -0.04 °C. This means they were fairly well aligned! However, when we looked at the proportion of measurements that fell within our agreed limit, only a small number of them did.

The nasopharyngeal and esophageal temperatures also had a similar story with a tiny difference of about 0.02 °C. Again, not too bad!

#Temperature Trends During HIPEC

While analyzing the data, we noticed how temperature changed during different times of the operation. Before, during, and after HIPEC, we checked the agreement between temperature readings. Overall, our findings indicated a strong connection between nasopharyngeal, forehead, and esophageal temperatures during the entire surgery.

However, we did see some interesting fluctuations. After HIPEC, temperatures increased across all measurement sites, particularly in the nasopharyngeal and forehead areas. This rebound heating could potentially lead to issues for the patient as their body adjusts.

#Why Temperature Monitoring is Key

Choosing where to monitor temperature during HIPEC is very important. The goal is to get a reliable reading to manage the patient’s condition effectively. Since the temperature in the brain closely relates to nasopharyngeal temperature, it makes sense to monitor it there.

The forehead thermometer is also an option, though it can sometimes give misleading readings. It’s been noted in other studies that the forehead measurements can differ by about 1 °C from the core temperature, which is significant.

Our results showed that even during rapid temperature changes, nasopharyngeal temperature and forehead measurements maintained a good correlation. The esophageal readings also did well, but they sometimes didn’t align perfectly with the others.

#Post-Surgery Observations

Another point of interest was that after the HIPEC procedure, temperatures dropped quickly, followed by a sudden rise. This could be a concern, as rapid temperature changes can put stress on the heart and blood vessels.

While studying these changes, we noticed the esophageal temperature often reflected that of the abdominal cavity, showing different behavior during surgery. This means we need to be vigilant when managing temperature changes during and after surgery.

#Conclusion

In summary, our study found strong connections between nasopharyngeal, forehead, and esophageal temperature readings during HIPEC with surgical treatment. However, there were noticeable differences that could lead to complications. Monitoring temperature effectively in these situations is vital, as temperature changes can affect patient outcomes significantly.

Being aware of how temperature impacts surgical procedures helps healthcare providers take better care of patients. It’s a serious business, but sometimes it's a little like a delicate dance where everyone must stay in sync to keep things running smoothly. After all, no one wants an unexpected temperature surprise!