In: Bleomycin17 Apr 2013
Since the study by Goldiner et al, several case reports have also implicated hyperoxia and fluid overload as causes of postoperative complications in bleomycin-treated patients. Other investigators attribute the absence of postoperative complications to the administration of a low FIo2 and limited fluids. antibiotics levaquin
Contrary to the recommendations of Goldiner et al, several studies have questioned the need to limit FIo2. A retrospective study at Vancouver General Hospital examined 14 bleomycin-treated patients with testicular cancer who subsequently came to surgery. These patients received an FIo2 of 0.3 to 1.0, with a mean of 0.37. There was only one postoperative pulmonary complication, which the patient survived. This patient returned for another procedure, FIo2 was kept in the range of 0.22 to 0.25, and there were no complications. In spite of the low incidence of complications, this group recommended that the guidelines of Goldiner et al be followed unless an adequate Pa02 cannot be maintained at a low FIo2.
LaMantia et al reviewed the records of 16 patients with testicular cancer treated with bleomycin who subsequently underwent general anesthesia. In this small retrospective study, patients were divided into two groups: group 1 had received an FIo2 greater than 0.3 during surgery, while group 2 had an FIo2 of less than 0.3. Only two pulmonary complications were reported.
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