Better outcomes for advanced ovarian cancer patients

Better outcomes for advanced ovarian cancer patients – with cardiac output monitor saving 21 hours in hospital stay.

A complex procedure for advanced ovarian cancer called Cytoreductive Surgery (CRS) is being guided by a haemodynamic monitor from Vygon, which has proven to reduce post operative complications and time spent in a high dependency unit by 45%.

A 21-hour reduction in length of stay in a high dependency unit was calculated by Norfolk and Norwich University Hospitals, which has been using two Mostcare Up devices to assist in CRS since 2019.

The technology monitors arterial blood pressure beat-by-beat and from these values calculates in depth haemodynamic parameters – meaning clinicians can accurately assess a patient’s condition, optimise fluid therapy and deliver appropriate treatment, without delay.

With fluid therapy critical to reducing complications, the Norfolk and Norwich team used goal-directed intra-operative fluid management (GDFM) based on readings from Mostcare Up, to make life-saving interventions.

Based on figures from over 100 patients, a significantly higher amount of fluid was received intraoperatively. This includes cases where over 23 litres had to be infused, based on the values observed from Mostcare Up. As a result, the hospital has identified a 100% reduction in respiratory or renal complications following the procedure.

Rocio Ochoa-Ferraro, consultant at Norfolk and Norwich University Hospitals, explains: “With this device, you get a better picture of how to treat your patients and you can target therapy to them. Mostcare Up makes it easier for our team to manage these difficult, challenging cases. And most importantly, the patients do better.

“It has changed our practice because using this monitor reduces the stress when dealing with difficult cases where you don’t know what you are dealing with from a cardiovascular or the cardiac point of view. It means you can conduct a high risk procedure using this tool to help you to assess the patient in real time.”

Due to ovarian cancer having few or no symptoms, around 75% of people are diagnosed when it’s at an advanced stage. Standard treatment for advanced ovarian cancer – meaning it has spread beyond where the tumor first started – is cytoreductive surgery (CRS), which is a complicated procedure involving surgery lasting between eight and 14 hours.

Muzzamil Ali, critical care specialist at Vygon, adds: “For these surgeries the blood loss is enormous and with such a fluid shift in a patient you need an accurate guide to make the right treatment decisions. That’s where Mostcare Up comes in.

“After initial use in the hospital’s Gynecology department, Mostcare Up is looking to be implemented in ICU. Because the equipment is intuitive and doesn’t require specialists to operate or interpret the results, it allows for nurse-led service. This frees up in-demand senior consultant time, so it’s really a win-win. Our feedback from the teams using it has been fantastic.”

Rocio concludes: “A challenge was convincing my senior colleagues of the value. In Intensive Care they didn’t believe in non-invasive cardiac output monitoring. Now there is evidence, they have introduced it.

“The most important thing is that the technology had to be easy to understand. That is key. If it’s difficult to set up, and difficult to interpret what the monitor is telling you, it is harder to realise the benefits. But this is simple and you can do it quickly.”

A multidisciplinary team at Norfolk and Norwich is now using the Mostcare Up as part of a complex procedure called HIPEC – hyperthermic intraperitoneal chemotherapy – which is used to tackle the most aggressive ovarian cancer cases. It involves washing a hot chemotherapy solution through the patient’s abdomen, in an attempt to kill off any cells the surgeons have not been able to detect. The hospital has won national accreditation and is the only established centre in the UK to offer this service to ovarian cancer patients as standard care.

Mostcare Up monitors a patient’s haemodynamic variables via any existing arterial line and, in addition to standard clinical parameters, it provides unique variables focusing on cardiac output and efficiency, vascular function and oxygen delivery, to assist in decision-making and goal directed therapy.

It can be set up and monitoring within just 60 seconds and used with both adults and children as a minimally invasive tool.
Mostcare Up is available as an outright purchase, or on a rental agreement to help Trusts manage budgets. To find out more about Mostcare

Up visit: https://vygon.co.uk/product/monitoring-critical-access/mostcareup/mostcareup-endless-code-vmb08mc0255e0v/