Veno-venous perfusion-induced systemic hyperthermia

Case report with perfusion considerations

R. A. Vertrees, J. B. Zwischenberger, L. C. Woodson, E. A. Bedell, D. J. Deyo, J. M. Chernin

    Research output: Contribution to journalArticle

    3 Citations (Scopus)

    Abstract

    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 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.

    Original languageEnglish (US)
    Pages (from-to)243-248
    Number of pages6
    JournalPerfusion
    Volume16
    Issue number3
    StatePublished - 2001

    Fingerprint

    Induced Hyperthermia
    cancer
    Fever
    Perfusion
    Cells
    Norepinephrine
    Intensive care units
    Lung Neoplasms
    Safety
    Neoplasms
    United States Food and Drug Administration
    Mechanical Ventilators
    Therapeutics
    Body Temperature
    Diuretics
    Cooling
    Intensive Care Units
    Disease Progression
    Temperature
    Hospitalization

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

    Cite this

    Vertrees, R. A., Zwischenberger, J. B., Woodson, L. C., Bedell, E. A., Deyo, D. J., & Chernin, J. M. (2001). Veno-venous perfusion-induced systemic hyperthermia: Case report with perfusion considerations. Perfusion, 16(3), 243-248.

    Veno-venous perfusion-induced systemic hyperthermia : Case report with perfusion considerations. / Vertrees, R. A.; Zwischenberger, J. B.; Woodson, L. C.; Bedell, E. A.; Deyo, D. J.; Chernin, J. M.

    In: Perfusion, Vol. 16, No. 3, 2001, p. 243-248.

    Research output: Contribution to journalArticle

    Vertrees, RA, Zwischenberger, JB, Woodson, LC, Bedell, EA, Deyo, DJ & Chernin, JM 2001, 'Veno-venous perfusion-induced systemic hyperthermia: Case report with perfusion considerations', Perfusion, vol. 16, no. 3, pp. 243-248.
    Vertrees RA, Zwischenberger JB, Woodson LC, Bedell EA, Deyo DJ, Chernin JM. Veno-venous perfusion-induced systemic hyperthermia: Case report with perfusion considerations. Perfusion. 2001;16(3):243-248.
    Vertrees, R. A. ; Zwischenberger, J. B. ; Woodson, L. C. ; Bedell, E. A. ; Deyo, D. J. ; Chernin, J. M. / Veno-venous perfusion-induced systemic hyperthermia : Case report with perfusion considerations. In: Perfusion. 2001 ; Vol. 16, No. 3. pp. 243-248.
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    AB - 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™ 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.

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