Anesthetic implications in patients with previous bleomycin exposure: a narrative review

Keywords:

Bleomycin, bleomycin lung toxicity, bleomycin-induced pneumonitis, oxygen, anesthesia


Published online: May 18 2024

https://doi.org/10.56126/

R. Vervoort1, K. Vermeulen1, A. Teunkens2

1 Department of Anaesthesiology, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium
2 Department of Cardiovascular Sciences, KU Leuven, University of Leuven, Biomedical Sciences Group, Herestraat 49, B-3000 Leuven, Belgium

Abstract

Bleomycin lung toxicity is still a big fear for many anesthetists and their patients after bleomycin therapy. Clinicians avoided using high oxygen concentrations and hypoxic mixtures perioperatively since early publications of fatal respiratory failure were thought to be caused by a high inspiratory oxygen fraction. Up until today, bleomycin is still a frequently used chemotherapeutic. Anesthetists will therefore encounter patients who were exposed to bleomycin. Several other risk factors like age, renal insufficiency, cumulative dose, and smoking have been linked to the development of bleomycin-induced pneumonitis (BIP), and recent insights have questioned the link between hyperoxia and lung toxicity. This review provides an overview of evidence- and opinion-based recommendations concerning

ActaAnaesthBelg-74-s1-Cover

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Volume 74, supplement 1.

Dec 2023.

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