Thermal induction and temperature control in the hyperthermic antiblastic regional perfusion with extra corporeal circulation.

An optimal treatment temperature choice is based on a compromise between the higher values desirable for best synergic effects between heat and drugs and the lower values required to avoid drug inactivation and tissue damage. Temperature uniformity throughout the limb under treatment favors approaching the highest temperature compatible with the above compromise. Several modifications have been introduced in the methodology during our experience consisting of more than 100 perfusions. The induction of true hyperthermic temperatures (41.5–41.8 °C) is achieved both heating the perfusate and directly heating the limb by means of a warm-water circulation blanket, thus insuring an optimal thermal flow to the superficial tissues. Devices in the extra-corporeal circuit have also been adopted to obtain a fast and accurate perfusate temperature control. The following results can be obtained: (a) a short delay time is required to reach the therapeutic temperature range; (b) the perfusate temperature is maintained at a value close to 40 ±0.5 °C during the whole hyper-thermic phase of the treatment; (c) the various districts of the limb are maintained at substantially homogeneous hyperthermic temperature.