Perioperative Considerations for Patients Treated with Bleomycin (14)

In: Bleomycin

16 Apr 2013

Perioperative Complications
In 1978, Goldiner et al published the first report of postanesthetic complications in patients who received bleomycin for germ cell tumors and later underwent retroperitoneal lymph node dissection or resection of pulmonary metastases. After reviewing the management of five bleomycin-treated patients who died of acute postoperative pulmonary complications, a prospective study of 12 patients was done, limiting the FIo2 and closely monitoring fluid therapy during surgery. These 12 patients experienced no pulmonary complications. The management of patients who died of postoperative pulmonary complications differed from that of the prospective group. antibiotic levaquin

The average FIo2 both during and after surgery was 0.24 in survivors vs 0.39 in the nonsurvivors. The crystalloid administered was 3.87 ml/kg/h in survivors, compared to 5.86 ml/kg/h in the nonsurvivors. Goldiner et al concluded that the FIo2 during and after surgery should be kept as low as possible and that fluid status should be aggressively monitored to avoid excessive crystalloid administration. These recommendations for anesthetic management remain the guidelines used by most anesthesiologists today.


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