University of Oulu

Tuovila, M., Erkinaro, T., Takala, H., Savolainen, E.-R., Laurila, P., Ohtonen, P., & Ala-Kokko, T. (2020). Hyperthermic intraperitoneal chemotherapy enhances blood coagulation perioperatively evaluated by thromboelastography: a pilot study. International Journal of Hyperthermia, 37(1), 293–300.

Hyperthermic intraperitoneal chemotherapy enhances blood coagulation perioperatively evaluated by thromboelastography : a pilot study

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Author: Tuovila, Mari1; Erkinaro, Tiina1; Takala, Heikki2;
Organizations: 1Department of Anesthesiology, Division of Intensive Care, Oulu University Hospital, Medical Research Center Oulu, University of Oulu, Oulu, Finland
2Division of Operative Care, Oulu University Hospital and Medical Research Center Oulu, University of Oulu, Oulu, Finland
3Nordlab Oulu Hematology Laboratory, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.2 MB)
Persistent link:
Language: English
Published: Informa, 2020
Publish Date: 2020-10-01


Background and Objectives: Postoperative thromboembolism is a significant cause of prolonged recovery in patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Thromboelastography (TEG) can detect hypercoagulable states and predict thromboembolic complications after surgery. This study assessed the impact of CRS and HIPEC on TEG values.

Methods: TEG parameters reaction time (R), kinetics time (K), angle (α), maximum amplitude (MA), and lysis percent at 60 min (LY60) were determined preoperatively, and at the end of CRS, during HIPEC, and at the end of the operation using blood samples from 15 HIPEC patients. Platelets, P-TT, and aPTT were also determined before and after CRS.

Results: A total of 75 samples were analyzed. During CRS, there was a significant reduction in the mean MA (3.06 mm, p = 0.001). The mean P-TT declined by 32% (p < 0.001) and mean platelets by 55 × 10⁹/L (p < 0.001). During HIPEC, the mean R and K shortened by 1.04 min (p = 0.015) and 0.18 min (p = 0.018), respectively, whereas α increased by 2.48° (p = 0.005).

Conclusions: During CRS, both TEG and conventional laboratory tests indicated hypocoagulation. During HIPEC, however, the initiation of coagulation and the kinetics of thrombin formation were accelerated.

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Series: International journal of hyperthermia
ISSN: 0265-6736
ISSN-E: 1464-5157
ISSN-L: 0265-6736
Volume: 37
Issue: 1
Pages: 293 - 300
DOI: 10.1080/02656736.2020.1742389
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Funding: This work was funded by Medical Reseach Center Oulu [3 months salary grant].
Copyright information: © 2020 The Author(s). Published with license by Taylor & Francis Group, LLC. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.