Anesthetic Challenges in A Heart Failure Patient for Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy: A Case Report

CRS-HIPEC is a procedure for the treatment of peritoneal malignancies. It is a multi-step procedure consisting of initial tumor debulking, followed by heated application of chemotherapy. Throughout the procedure multiple physiologic changes occur: large fluid losses and shifts, hemodynamic derangements, extremes of temperatures. Knowledge of the physiologic changes during each phase is essential in forming an anesthetic plan for this case. For this particular case, the patient has an ejection fraction of 35%. The reduced ejection fraction requires careful attention and modification in management. Thus, a tailored anesthetic plan is of particular importance. There is a scarcity of studies regarding anesthetic management in a heart failure patient for CRS-HIPEC, hence it is important to explore the implications of this disease process on anesthetic management.