Elsevier

Critical Care Clinics

Volume 26, Issue 1, January 2010, Pages 93-106
Critical Care Clinics

Critical Care Issues in Oncological Surgery Patients

https://doi.org/10.1016/j.ccc.2009.10.004Get rights and content

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Cytoreductive surgery and heated intraperitoneal chemotherapy

CRS with HIPEC is emerging as a therapeutic option for advanced, locally metastatic abdominal cavity cancer or peritoneal carcinomatosis. In peritoneal cancer, intravenous chemotherapy is ineffective. CRS encompasses extensive tumor debulking with visceral and parietal peritonectomy, resection of omentum, and resections of involved abdominal viscera such as stomach, small bowel, colon, spleen, liver, gall bladder, pancreas, bladder, diaphragm, and abdominal wall.4, 5, 6 HIPEC is the

Airway Management

In critically ill patients, tracheal intubation is considerably more difficult due to factors such as encephalopathy, respiratory dysfunction, oropharyngeal secretions, hemodynamic instability, bleeding, vomiting, and airway edema. As the number of laryngoscopic intubation attempts increase, complications such as hypoxemia, aspiration, bradycardia, and cardiac arrest increase significantly.32

Traditional endotracheal intubation performed via direct laryngoscopy using devices such as the

Summary

As life expectancy increases and advances in cancer treatment more often convert deadly conditions into more chronic diseases, the surgical intensivist can expect to be faced with greater numbers of oncology patients undergoing aggressive surgical treatments for curative intent, prolonging survival, or primary palliation by alleviating obstruction, infection, bleeding, or pain. CRS and HIPEC are a paradigm for the emerging field of multimodal aggressive oncological surgery. A discussion of the

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    The authors state that they do not have any conflicts of interest.

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