Hemodynamic effects of aortic stop flow and total abdominal ischemic perfusion

Total abdominal perfusion (TAP) and stopflow (SF) are recently described techniques used for regional chemotherapy in advanced abdominal cancer, The abdominal organs are isolated from the systemic circulation and perfused by means of external pump. We studied the hemodynamic changes observed after clamping/declamping of the abdominal aorta (ACL, ADCL) and inferior vena cava (VCL, VDCL) during the procedure. A group of 10 pts was treated by TAP/SF. In each patient balloon tipped pulmonary artery catheter with SVO2 probe was inserted. Hemodynamic and respiratory parameter's were monitored during the procedure at baseline (BL) and following ACL and ADCL. In some cases (TAP) inferior caval clamping/declamping was performed as well, ACL produced an increase in BP and PCWP, whereas EtCO2 and CO were moderately decreased. Addition of VCL did not produce further hemodynamic changes. Following declamping, a decrease in BP and increase in CO were observed. Again, caval declamping did not affect the hemodynamics. Our results suggest that occlusion of the abdominal aorta produce expected physiological results. The addition of vena caval occlusion after aortic clamping does not alter the hemodynamic course.