Stroma-free hemoglobin: its presence in plasma does not improve oxygen supply to the resting hindlimb vascular bed of hemodiluted dogs

1991 ◽  
Vol 69 (11) ◽  
pp. 1656-1662 ◽  
Author(s):  
George P. Biro ◽  
Peter J. Anderson ◽  
Scott E. Curtis ◽  
Stephen M. Cain
Keyword(s):  
Vascular Resistance ◽  
Oxygen Delivery ◽  
Oxygen Supply ◽  
Oxygen Extraction ◽  
Free Hemoglobin ◽  
Hemoglobin Solution ◽  
Arterial Blood ◽  
Vascular Bed ◽  
Critical Oxygen ◽  
Plasma Phase

In hemodilution, red cell spacing in the microcirculation is increased, flow distribution may become more heterogeneous, and, as a result, oxygen supply to tissues may suffer. We tested the hypothesis that oxygen extraction from diluted blood may be enhanced by the presence of hemoglobin in the plasma phase in relatively low concentrations. In anesthetized dogs, the hindlimb vascular bed was isolated and perfused with the animal's own blood by a roller pump. One group of dogs (n = 6) was hemodiluted (hematocrit = 15.0 ± 1.0%) with a 6% solution of dextran. A second group of dogs (n = 6) was similarly hemodiluted (hematocrit = 16.0 ± 0.4%) with dextran containing stroma-free hemoglobin solution whereby plasma-phase hemoglobin concentration was raised to 1.1 ± 0.1 g∙dLé−1. Systemic hemodynamic observations were made repeatedly over the subsequent 2.5 h, while blood flow to the hindlimb was progressively reduced in stepwise decrements. The hemoglobin-hemodiluted group showed increased systemic arterial blood pressure and total peripheral resistance when compared with the control (dextran diluted) group. The isolated hindlimb also showed evidence of increased vascular resistance in the hemoglobin-treated group. In each individual animal, critical oxygen delivery and extraction were determined by finding the intercept of the supply-independent and supply-dependent portions of the oxygen uptake/oxygen delivery relationship. Neither the critical oxygen delivery rates (5.75 ± 0.83 vs. 6.41 ± 0.53 mL∙kg−1 min−1) nor critical oxygen extraction ratios (0.75 ± 0.03 vs. 0.76 ± 0.04) were found to be significantly different in the two groups. We conclude that hemoglobin in solution in the plasma at a concentration of about 1 g∙dL−1 induces significant increase in vascular resistance and fails to augment oxygen extraction from diluted blood by the resting hindlimb.Key words: stroma-free hemoglobin solution, oxygen extraction, vasoconstriction, isolated hindlimb vascular bed, oxygen supply.

scholarly journals Differentiated approach to treatment of arterial hypertension in patients, suffering ischemic cerebral stroke

2020 ◽  
Vol 87 (1-2) ◽  
pp. 47-52
Author(s):  
K. V. Serikov ◽  
L. M. Smyrnova ◽  
O. F. Dzygal
Keyword(s):  
Cardiac Index ◽  
Arterial Hypertension ◽  
Vascular Resistance ◽  
Antihypertensive Therapy ◽  
Oxygen Delivery ◽  
Peripheral Vascular Resistance ◽  
Cerebral Stroke ◽  
Middle Grade ◽  
Peripheral Vascular ◽  
Arterial Blood

Objective. To raise the efficacy of treatment of arterial hypertension in patients, suffering ischemic cerebral stroke of the middle grade of severity on background of determination of hemodynamic variant of arterial hypertension. Materials and methods. Prospective nonrandomized investigation concerning 42 patients, suffering ischemic cerebral stroke of middle severity in accordance to the insult severity scale of National Institute of Health (National Institutes of Health Stroke Scale - NIHSS), was conducted. The patients’ middle age have constituted (69.4 ± 1.4) yrs. There were the central hemodynamic indices measured, the arterial hypertension hemodynamic variant determined, the oxygen and hemodynamic status estimated, and in accordance to the results obtained - the differentiated antihypertensive therapy was administered. All the patients were divided into three groups, depending on hemodynamical variant of arterial hypertension: the first group – patients with eukinetic variant, the second group – patients with hypokinetic variant, the third group – patients with hyperkinetic variant. Hemodynamical variant of arterial hypertension was determined in accordance to the referent level of cardiac index. The groups were representative in accordance to age, height, the body mass, the main and concurrent pathology and the cerebral affection degree. Results. In the patients, suffering initial eukinetic hemodynamical variant of arterial hypertension, the cardiac index have fluctuated from 2.88 to 4.67 l × min-1 × m-2, general peripheral vascular resistance have rested in the norm borders, the oxygen saturation level of arterial blood did not demand the oxygen therapy, index of the oxygen delivery have exceeded the appropriate values and fluctuated in borders from 541 to 903 l × min-1 × m-2. In complex of differentiated antihypertensive therapy there was applied a constant intravenous injection of magnesium sulfate in a daily dose 2500 - 5000 mg. For patients with initial hypokinetic hemodynamic variant of arterial hypertension following signs are characteristic: low cardiac index - from 1.65 to 2.08 l × min-1 × m-2, the enhanced general peripheral vascular resistance - 2813 (from 2393 to 3403) dyne × s-1 × cm-5 and the lowered index of the oxygen delivery - from 306 to 412 l × min-1 × m-2. Differentiated antihypertensive therapy was conducted, using urapidyl: intravenous boluses 1.25 – 2.5 mg with further infusion 5 - 40 mg × h-1. For hyperkinetic hemodynamic variant of arterial hypertension the raised cardiac index is characteristic – 3.75 l × min-1 × m-2 (fluctuated in borders from 3.62 to 4.10 l × min-1 × m-2), as well as normal general peripheral vascular resistance - 1189 (from 1055 to 1449) dyne × s-1 × cm-5 and raised index of the oxygen delivery - 762 (from 725 to 828) l × min-1 × m-2. Differentiated antihypertensive therapy was conducted, using labetalol: intravenous infusion with velocity 2 - 8 mg × min-1. Conclusion. In the patients with ischemic cerebral stroke of the middle grade of severity the conduction of differentiated antihypertensive therapy, taking into account hemodynamic type of arterial hypertension and the oxygen-hemodynamic stabilization of the blood circulation system, improved the results of treatment and accelerated the rehabilitation duration.

Acute Cardiovascular and Hematologic Changes After a Single Transfusion Demonstrate Sex Differences in Chronically Transfused Sickle Cell Anemia Patients

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2138-2138
Author(s):  
Jon Detterich ◽  
Roberta Miyeko Kato ◽  
Ani Dongelyan ◽  
Adam Bush ◽  
Herbert J. Meiselman ◽  
...  
Keyword(s):  
Platelet Count ◽  
Cardiac Index ◽  
Vascular Resistance ◽  
Carrying Capacity ◽  
Oxygen Delivery ◽  
Reticulocyte Count ◽  
Free Hemoglobin ◽  
Hemoglobin S ◽  
Oxygen Carrying Capacity

Abstract Abstract 2138 Chronic transfusion therapy (CTT) is a mainstay for stroke prophylaxis in sickle cell anemia. Long-term changes with transfusion include decreased hemoglobin S% and hemolysis resulting in decreased plasma free hemoglobin. Long-term benefits are well documented, however, patients on CTT continue to suffer from acute crises. The acute effects of each transfusion are not well known but might include improved oxygen carrying capacity secondary to increased hematocrit, reducing demands for high cardiac output. But, the increased hematocrit and oxygen carrying capacity is at the cost of increased viscosity and resistance to blood flow. Despite long-term benefits, acute complications continue to plague this patient population and could be due to acute rheologic changes with transfusion. We hypothesized that transfusion would acutely improve tissue oxygen delivery despite increasing blood viscosity and vascular resistance. To test this hypothesis, we prospectively examined patients on CTT immediately pre transfusion and again 12–120 hours post transfusion. Hemodynamics were tested by measuring blood pressure, heart rate and cardiac function by echocardiography. Tissue oxygen delivery was assessed using echocardiographic estimates of cardiac output, pulse oximetry and oxygen carrying capacity as well as near infrared spectroscopy (NIRS). We obtained basic hematology and metabolic labs in addition to markers of inflammation, hemolysis and amino acid profile at both visits. Male and female patients were equally represented with similar average age. The reasons for starting transfusion as well as medication profiles were similar between sexes. Comparable changes in hemoglobin, hematocrit, reticulocyte count and hemoglobin S with transfusion were observed in all patients. However, when pre transfusion levels of free hemoglobin, hemoglobin S%, platelet count and reticulocyte count were examined with regard to timing from the previous transfusion, males had faster recovery of endogenous marrow activity and increased hemolysis, producing higher average hemoglobin S%, reticulocyte count, platelet count and free hemoglobin levels (figure 1). In males, transfusion decreased heart rate, stroke volume, and cardiac index while estimates for pulmonary and systemic vascular resistance rose, culminating in decreased oxygen delivery. In contrast, stroke volume and cardiac index were preserved in women following transfusion, while systemic and pulmonary vascular resistance did not change such that oxygen delivery improved 16%. NIRS measurements assessing tissue oxygenation confirmed the differences seen using echocardiography and oxygen carrying capacity estimates(figure 2).Figure 1Figure 1. Figure 2Figure 2. Increased endogenous marrow activity in males, resulting in higher pre-transfusion reticulocyte count, hemoglobin S%, platelet count and free hemoglobin might account for the exaggerated reduction in cardiac index, as well as increased systemic and pulmonary vascular resistance with transfusion. In addition, the faster recovery of hemoglobin S% and hemolysis likely confers increased risk of vascular complications in male patients despite chronic transfusion therapy. Disclosures: Wood: Novartis: Research Funding; Ferrokin Biosciences: Consultancy; Cooleys Anemia Foundation: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding.

scholarly journals Effect of crystalloid administration on oxygen extraction in endotoxemic pigs

1998 ◽  
Vol 85 (5) ◽  
pp. 1667-1675 ◽  
Author(s):  
Kenneth W. Gow ◽  
P. Terry Phang ◽  
Susan M. Tebbutt-Speirs ◽  
John C. English ◽  
Michael F. Allard ◽  
...  
Keyword(s):  
Oxygen Delivery ◽  
Area Fraction ◽  
Oxygen Extraction ◽  
Relative Dispersion ◽  
Tissue Oxygen ◽  
Interstitial Edema ◽  
Transit Times ◽  
Critical Oxygen ◽  
Saline Administration ◽  
Crystalloid Administration

We asked whether crystalloid administration improves tissue oxygen extraction in endotoxicosis. Four groups of anesthetized pigs ( n = 8/group) received either normal saline infusion or no saline and either endotoxin or no endotoxin. We measured whole body (WB) and gut oxygen delivery and consumption during hemorrhage to determine the critical oxygen extraction ratio ([Formula: see text]). Just after onset of ischemia (critical oxygen delivery rate), gut was removed for determination of area fraction of interstitial edema and capillary hematocrit. Radiolabeled microspheres were used to determine erythrocyte transit time for the gut. Endotoxin decreased WB[Formula: see text](0.82 ± 0.06 to 0.55 ± 0.08, P < 0.05) and gut[Formula: see text](0.77 ± 0.07 to 0.52 ± 0.06, P< 0.05). Unexpectedly, saline administration also decreased WB[Formula: see text](0.82 ± 0.06 to 0.62 ± 0.08, P< 0.05) and gut[Formula: see text](0.77 ± 0.07 to 0.67 ± 0.06, P< 0.05) in nonendotoxin pigs. Saline administration increased the area fraction of interstitial space ( P< 0.05) and resulted in arterial hemodilution ( P < 0.05) but not capillary hemodilution ( P > 0.05). Saline increased the relative dispersion of erythrocyte transit times from 0.33 ± 0.08 to 0.72 ± 0.53 ( P< 0.05). Thus saline administration impairs tissue oxygen extraction possibly by increasing interstitial edema or increasing heterogeneity of microvascular erythrocyte transit times.

Effect of Acute Respiratory Acidosis on the Limits of Oxygen Extraction during Hemorrhage

1996 ◽  
Vol 85 (4) ◽  
pp. 817-822 ◽  
Author(s):  
Michael E. Ward
Keyword(s):  
Blood Flow ◽  
Oxygen Consumption ◽  
Oxygen Content ◽  
Oxygen Delivery ◽  
Tissue Oxygenation ◽  
Respiratory Acidosis ◽  
Oxygen Availability ◽  
Oxygen Extraction ◽  
Oxygen Extraction Ratio ◽  
Critical Oxygen

Background Hypercapnia can impair cells' capacity to maintain energy status anerobically and enhances the risk of hypoxic injury when oxygen availability is reduced. The ability to maintain tissue oxygenation is determined by both bulk blood flow and the efficiency of oxygen extraction. Bulk blood flow is maintained during hypercapnia through increased sympathetic activity. The effect of hypercapnia on oxygen extraction, however, is unknown. This study evaluates the effect of hypercapnia on cells' capacity to adapt to reductions in oxygen availability by increasing oxygen extraction. Methods In three groups of paralyzed, mechanically ventilated dogs that were anesthetized with alpha-chloralose, the concentration of carbon dioxide in the inhaled gas mixture was adjusted to achieve normocapnia, moderate hypercapnia (Paco2 = 72 +/- 3 [SE] mmHg) or severe hypercapnia (Paco2 = 118 +/- 4 [SE] mmHg). Stepwise hemorrhage was induced until each dog's blood pressure was destabilized. At each stage in the hemorrhage protocol, the oxygen delivery, oxygen consumption, and oxygen extraction ratios (ratio of arteriovenous oxygen content difference to arterial oxygen content) were determined. Results At the point of onset of delivery dependence of oxygen consumption, the oxygen delivery rate (critical oxygen delivery) was 7.8 +/- 1.5 (SE) ml.kg-1.min-1 and the oxygen extraction ratio (critical oxygen extraction ratio) was 0.72 +/- 0.04 (SE) in the normocapnic dogs. Moderate hypercapnia had no effect on these parameters. In the severely hypercapnic dogs, the critical values for oxygen delivery and extraction ratios were 12.5 +/- 1.8 (SE) ml.kg-1.min-1 and 0.54 +/- 0.035 (SE), respectively (P &lt; 0.05 for differences from the normocapnic dogs). Conclusions The results identify a previously unrecognized threat to tissue oxygenation and emphasize the importance of ensuring adequate oxygen delivery when adopting mechanical ventilatory strategies that permit respiratory acidosis to develop.

Effects of afferent neural stimulation on critical oxygen delivery: a hemodynamic explanation

1995 ◽  
Vol 269 (6) ◽  
pp. R1448-R1454 ◽  
Author(s):  
E. Kirkman ◽  
H. Zhang ◽  
H. Spapen ◽  
R. A. Little ◽  
J. L. Vincent
Keyword(s):  
Blood Flow ◽  
Oxygen Delivery ◽  
Nerve Fibers ◽  
Afferent Nerve ◽  
Oxygen Extraction ◽  
Whole Body ◽  
Afferent Nerve Fibers ◽  
Femoral Blood Flow ◽  
Critical Oxygen ◽  
Renal Flow

Injury and activation of somatic afferent nerve fibers may alter critical oxygen delivery (DO2C), the point at which oxygen consumption becomes dependent upon delivery, and hence reduce tolerance to hypovolemia. The present study investigated the mechanism of this. Anesthetized mongrel dogs were divided into two groups: control (n = 6) and those subject to brachial nerve stimulation (BNS; n = 5). Whole body oxygen delivery (DO2I) and consumption were initially similar in both groups. DO2I was reduced by cardiac tamponade to determine DO2C. DO2C was significantly higher in BNS compared with control (11.5: 11.0-16.7 vs. 7.5: 6.9-9.5 ml.min-1.kg-1; median: Q1 - Q3), whereas critical oxygen extraction ratios were lower (54.8: 39.7-61.2 vs. 78.3: 53.5-92.4%). At approximately DO2C, normalized femoral blood flow was lower than renal flow in control (renal-femoral difference 17.4: 8.7-40.0%) but not in BNS (-7.8: -14.8 to +11.8%). These results indicate that activation of somatic afferent nerve fibers elevates DO2C. This could be due to an impairment in peripheral oxygen extraction as a consequence of a redistribution of blood flow away from metabolically active vital organs toward relatively inactive skeletal muscle.

Group B Streptococcus-induced acidosis in newborn swine: regional oxygen transport and lactate flux

1992 ◽  
Vol 72 (1) ◽  
pp. 272-277 ◽  
Author(s):  
E. S. Barefield ◽  
W. Oh ◽  
B. S. Stonestreet
Keyword(s):  
Metabolic Acidosis ◽  
Oxygen Uptake ◽  
Oxygen Delivery ◽  
Group B Streptococcus ◽  
Lactate Concentration ◽  
Oxygen Metabolism ◽  
Oxygen Extraction ◽  
Vascular Bed ◽  
Vascular Beds ◽  
Group B

To investigate the mechanism of metabolic acidosis resulting from group B streptococcal sepsis, oxygen metabolism and lactate flux of the cerebrum, hindlimb, liver, splanchnic organs, and systemic vascular bed as a whole were examined. Nine 3- to 5-day-old awake and spontaneously breathing piglets were studied before and after 3, 4, and 5 h of continuous live group B Streptococcus infusion. After 5 h, oxygen delivery was decreased to all organs and to the whole systemic vascular bed. Increased oxygen extraction compensated for reduced oxygen delivery in the liver and splanchnic organs; however, it only partially offset reduced oxygen delivery to the hindlimb and systemic vascular bed. Cerebral oxygen extraction did not increase. As a result, oxygen uptake was reduced in the cerebrum, hindlimb, and systemic vascular bed. At 5 h of bacterial infusion, arterial lactate concentration was increased with regional lactate efflux from the cerebrum and hindlimb and influx to the liver (P less than 0.05 vs. zero or no net flux). We conclude that group B Streptococcus-induced metabolic acidosis is associated with regional lactate efflux from vascular beds in which oxygen uptake is reduced. We speculate that the quantity of net lactate efflux from vascular beds with insufficient oxygen uptake exceeds the net influx into organs such as the liver, resulting in metabolic acidosis.

Catecholamine and serotonin concentrations in fetal guinea-pig brain: relation to regional cerebral blood flow and oxygen delivery in the growth-restricted fetus

1996 ◽  
Vol 8 (3) ◽  
pp. 355 ◽  
Author(s):  
A Jensen ◽  
HJ Klonne ◽  
A Detmer ◽  
AM Carter
Keyword(s):  
Blood Flow ◽  
Guinea Pig ◽  
Oxygen Delivery ◽  
Oxygen Supply ◽  
Tissue Concentrations ◽  
Blood Flows ◽  
Arterial Blood ◽  
Tissue Po2 ◽  
The Brain ◽  
Neurotransmitter Metabolism

To test the hypothesis that intrauterine growth restriction (IUGR) would lead to altered neurotransmitter metabolism in the brain because of poorer oxygenation, blood flows and tissue concentrations of noradrenaline, dopamine, serotonin and their metabolites were measured in 14 parts of the brain of guinea-pig fetuses at 61-64 days' gestation. Eight fetuses with IUGR induced by uterine artery ligation were compared with 8 controls. Regional brain blood flows were determined by the microsphere method and tissue concentrations of monoamines by HPLC with electrochemical detection. The oxygen content of preductal arterial blood was significantly lower in IUGR fetuses than in controls (2.3 +/- 0.6 v. 3.5 +/- 0.5 mM; P < 0.001). Although this was compensated by increases in blood flow to many areas of the brain, significant decreases occurred in oxygen delivery to the temporal and occipital cortex, hippocampus and cerebellum of IUGR fetuses. In contrast, oxygen delivery to brainstem areas was maintained. Noradrenaline concentrations were closely similar in brains from the two groups, except for an increase in the caudate nucleus of IUGR fetuses. Dopamine concentrations were significantly elevated in brainstem areas. Concentrations of 3,4-dihydroxyphenylglycol (DOPEG), a noradrenaline metabolite, and 3,4-dihydroxyphenylacetic acid (DOPAC), a dopamine metabolite, showed a similar pattern of increase in brains of IUGR fetuses, possibly resulting from increased synthesis of noradrenaline and dopamine rather than from decreased degradation. Concentrations of serotonin were significantly higher in frontal and temporal cortex of IUGR fetuses, and the serotonin metabolite 5-HIAA increased significantly in cortical areas. Changes in neurotransmitter metabolism could not be related to oxygen supply, since serotonin concentrations increased in the forebrain, despite reduced oxygen delivery and the known dependence of tryptophan-5-hydroxylase on tissue PO2, and dopamine levels were elevated in the brainstem, where the oxygen supply was maintained.

Intestinal and Cerebral Oxygenation during Severe Isovolemic Hemodilution and Subsequent Hyperoxic Ventilation in a Pig Model

2002 ◽  
Vol 97 (3) ◽  
pp. 660-670 ◽  
Author(s):  
Jasper van Bommel ◽  
Adrianus Trouwborst ◽  
Lothar Schwarte ◽  
Martin Siegemund ◽  
Can Ince ◽  
...  
Keyword(s):  
Oxygen Consumption ◽  
Oxygen Delivery ◽  
Oxygen Supply ◽  
Cerebral Oxygenation ◽  
Oxygen Extraction ◽  
Control Group ◽  
Isovolemic Hemodilution ◽  
Systemic Oxygen ◽  
Fraction Of Inspired Oxygen ◽  
Hyperoxic Ventilation

Background During severe isovolemic hemodilution, determination of critical hematocrit levels for the microvascular oxygenation of different organs might provide more insight into the effect of the redistribution of blood flow and oxygen delivery on the oxygenation of different organs. The effect of an increased amount of dissolved oxygen on tissue oxygenation during severely decreased hematocrit levels is not clear. Methods Fifteen anesthetized pigs were randomized between an experimental group (n = 10), in which severe isovolemic hemodilution was performed with 6% hydroxyethylstarch (1:1), and a time-matched control group (n = 5). Systemic, intestinal, and cerebral hemodynamic and oxygenation parameters were monitored. Microvascular oxygen partial pressure (muPo(2) ) was measured in the cerebral cortex and the intestinal serosa and mucosa, using the oxygen-dependent quenching of Pd-porphyrin phosphorescence. In the final phase of the experiment, fraction of inspired oxygen was increased to 1.0. Results Hemodilution decreased hematocrit from 25.3 +/- 3.0 to 7.6 +/- 1.2% (mean +/- SD). Systemic and intestinal oxygen delivery fell with the onset of hemodilution; intestinal oxygen consumption deceased at a hematocrit of 9.9%, whereas the systemic oxygen consumption decreased at a hematocrit of 7.6%. During hemodilution, the intestinal and cerebral oxygen extraction ratios increased from baseline with 130 and 52%, respectively. Based on the intersection of the two best-fit regression lines, determined by a least sum of squares technique, similar critical hematocrit levels were found for systemic oxygen consumption and the cerebral and intestinal mucosa muPo(2); the intestinal serosa muPo(2) decreased at an earlier stage (P &lt; 0.05). Hyperoxic ventilation improved the muPo(2) values but not systemic or intestinal oxygen consumption. Conclusions During isovolemic hemodilution, the diminished oxygen supply was redistributed in favor of organs with a lower capacity to increase oxygen extraction. It is hypothesized that redirection of the oxygen supply within the intestines resulted in the preservation of oxygen consumption and mucosal muPo(2) compared with serosal muPo(2).

scholarly journals Physiologic and hemodynamic changes in patients undergoing open abdominal cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098326
Author(s):  
Myoung Hwa Kim ◽  
Young Chul Yoo ◽  
Sun Joon Bai ◽  
Kang-Young Lee ◽  
Nayeon Kim ◽  
...  
Keyword(s):  
Body Temperature ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Resistance Index ◽  
Volume Index ◽  
Hemodynamic Changes ◽  
Arterial Blood

Objective We aimed to determine the physiological and hemodynamic changes in patients who were undergoing hyperthermic intraperitoneal chemotherapy (HIPEC) cytoreductive surgeries. Methods This prospective, observational study enrolled 21 patients who were undergoing elective cytoreductive surgery with HIPEC at our hospital over 2 years. We collected vital signs, hemodynamic parameters including global end-diastolic volume index (GEVI) and extravascular lung water index (ELWI) using the VolumeView™ system, and arterial blood gas analysis from all patients. Data were recorded before skin incision (T1); 30 minutes before HIPEC initiation (T2); 30 (T3), 60 (T4), and 90 (T5) minutes after HIPEC initiation; 30 minutes after HIPEC completion (T6); and 10 minutes before surgery completion (T7). Results Patients showed an increase in body temperature and cardiac index and a decrease in the systemic vascular resistance index. GEDI was 715.4 (T1) to 809.7 (T6), and ELWI was 6.9 (T1) to 7.3 (T5). Conclusions HIPEC increased patients’ body temperature and cardiac output and decreased systemic vascular resistance. Although parameters that were extracted from the VolumeView™ system were within their normal ranges, transpulmonary thermodilution approach is helpful in intraoperative hemodynamic management during open abdominal cytoreductive surgery with HIPEC. Trial registry name: ClinicalTrials.gov Trial registration number: NCT02325648 URL: https://clinicaltrials.gov/ct2/results?cond=NCT02325648&term

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