Bleomycin and perioperative care: a case report
Main Article Content
Keywords
Bleomycin, Cancer, Oxygen, Perioperative care, Pulmonary toxicity
Abstract
Bleomycin is associated with pulmonary toxicity ranging from pneumonitis, pulmonary fibrosis, to fatal acute respiratory distress syndrome. Oxygen administration can potentiate or precipitate bleomycin pulmonary toxicity, and the most common setting of oxygen exposure is during anesthesia. We report here the successful management and perioperative care of a patient with documented bleomycin pulmonary toxicity who had to undergo an eight hour long retroperitoneal surgery. With proper preoperative assessment, chest physiotherapy, inhaled steroids and bronchodilators, antibiotics, operative restriction of oxygen and fluids and good postoperative care no further pulmonary insult was inflicted.
References
2. Wuethrich PY, Burkhard FC. No Perioperative pulmonary complications after restricted oxygen exposition in bleomycin-treated patients: A short report. ISRN Anesthesiol. 2011;2011:1–3.
3. Goldiner PL, Carlon GC, Cvitkovic E, Schweizer O, Howland WS. Factors influencing postoperative morbidity and mortality in patients treated with bleomycin. Br Med J. 1978 ;1 (6128):1664–7.
4. Gilson AJ, Sahn SA. Reactivation of bleomycin lung toxicity following oxygen administration. Chest. 1985;88:304–6.
5. Aakre BM, Efem RI, Wilson GA, Kor DJ, Eisenach JH. Postoperative acute respiratory distress syndrome in patients with previous exposure to bleomycin. Mayo Clin Proc. 2014;89:181–9.
6. Donat SM, Levy DA. Bleomycin associated pulmonary toxicity: is perioperative oxygen restriction necessary? J Urol. 1998;160:1347–52.
7. LaMantia KR, Glick JH, Marshall BE. Supplemental oxygen does not cause respiratory failure in bleomycin-treated surgical patients. Anesthesiology. 1984;60:65–6.
8. Waid-Jones MI, Coursin DB. Perioperative considerations for patients treated with bleomycin. Chest. 1991;99:993–9.
9. Ingrassia TS, Ryu JH, Trastek VF, Rosenow EC. Oxygen-exacerbated bleomycin pulmonary toxicity. Mayo Clin Proc. 1991;66:173–8.
10. Patel NM, Kulkarni T, Dilling D, Scholand MB, Gupta N, Strek M, et al. Preoperative evaluation of patients with interstitial lung disease. Chest. 2019;156:826–33.
11. Gao S, Barello S, Chen L, Chen C, Che G, Cai K, et al. Clinical guidelines on perioperative management strategies for enhanced recovery after lung surgery. Transl Lung Cancer Res. 2019;8:1174–87.
12. Zhu X, Zhang P, Lou C, Wu J. Perioperative inhaled corticosteroids treatment is associated with decreased length-of-stay and direct medical costs in high-respiratory-risk surgeries. J Med Econ. 2020;23:280–6.
Article Sidebar
Article Details
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
B Jayakrishnan, Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Oman.
Senior Consultant, Division of Pulmonology, Head &Neck and Thoracic Program,
Rajini Kausalya , Sultan Qaboos Comprehensive Cancer Care &Research Centre
Senior Consultant, Department of Anaesthesia
Hilal A Al-Rashdi, Sultan Qaboos Comprehensive Cancer Care &Research Centre,Muscat,Oman
Consultant Urologist, Genitourinary Program
Kirubakaran Davis , Sultan Qaboos Comprehensive Cancer Care &Research Centre
Consultant, Department of Anaesthesia
Jahfar Ali, Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Oman.
Specialist, Department of Anaesthesia
Munjid Al-Harthy , Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Oman.
6Consultant Oncologist, Genitourinary Program
Sami M Bennji, Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Oman.
Consultant, Division of Pulmonology, Head &Neck and Thoracic Program
How to Cite
