Anaesthetic management of extra-pleural pneumonectomy and hyperthermic intrathoracic chemotherapy procedure.

Malignant pleural mesothelioma is a rare tumour with survival of 9-17 months after diagnosis. Radical surgical resection by extra-pleural pneumonectomy combined with hyperthermic intrathoracic chemotherapy has shown to improve patient survival and better microscopic tumour control. Anaesthetic management of this procedure is challenging due to the complex pathophysiological changes associated with prolonged duration of surgery, one- lung ventilation, haemodynamic instability due to major blood loss, temperature variations including heat loss during pneumonectomy and rapid rise in temperature during hyperthermic chemotherapy, cardiac arrhythmias due to exposure to heated chemotherapeutics, cisplatin toxicity and acid-base changes.

Implications of ICU stay after brain death: the Saudi experience.

Objective: The interval from brain death (BD) to organ harvesting is critical to the success of transplantation. We evaluated the time from BD onset to harvesting and analyzed sources of delay.

Materials And Methods: This retrospective study was conducted from January 1999 to December 2003.