title: Severe hyponatremia, hyperglycemia, and hyperlactatemia are associated with intraoperative hyperthermic intraperitoneal chemoperfusion with oxaliplatin.
abstract: BACKGROUND
  Since the introduction of surgical debulking in combination with intraoperative hyperthermic intraperitoneal chemoperfusion (HIPEC) with oxaliplatin in our institution, severe hyponatremia (sodium: 126.5 +/- 3.8 mmol/L), hyperglycemia (glucose: 22.37 +/- 4.89 mmol/L), and hyperlactatemia (lactate: 3.17 +/- 1.09 mmol/L) have been observed post HIPEC. This metabolic disorder was not observed in patients in whom cisplatin or mitomycin C was used as a chemotherapeutic drug.
  
  
  METHODS
  In order to understand the pathophysiology of this finding, an analysis of our data was made. In a first analysis, plasma sodium was corrected for hyperglycemia based on the formula of Hillier. In a second analysis, the influence of total exchangeable sodium, total exchangeable potassium, and total body water on plasma sodium concentration was modeled.
  
  
  RESULTS
  Analysis of our data revealed a double mechanism for the observed metabolic disorder: hyperglycemia caused by dextrose 5%, which is used as a carrier for the oxaliplatin, and major loss of sodium into the dialysate (256.7 +/- 68.7 mmol).
  
  
  CONCLUSIONS
  Better control of hyperglycemia and intravenous compensation of sodium loss into the dialysate can attenuate the reported biochemical disturbance.
authors.affiliation: Department of Cardiac Surgery, University Hospital Ghent, Ghent, Belgium. Filip.DeSomer@ugent.be
authors.forename: Filip
authors.initials: F
authors.lastname: De Somer
authors.forename: Wim
authors.initials: W
authors.lastname: Ceelen
authors.forename: Joris
authors.initials: J
authors.lastname: Delanghe
authors.forename: Dirk
authors.initials: D
authors.lastname: De Smet
authors.forename: Martin
authors.initials: M
authors.lastname: Vanackere
authors.forename: Piet
authors.initials: P
authors.lastname: Pattyn
authors.forename: Eric
authors.initials: E
authors.lastname: Mortier
mesh_terms: D000008:Abdominal Neoplasms / Q000188:drug therapy / Q000601:surgery; D000140:Acidosis, Lactic / Q000209:etiology* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001786:Blood Glucose / Q000378:metabolism; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology* / Q000503:physiopathology; D006979:Hyperthermia, Induced / Q000009:adverse effects; D007010:Hyponatremia / Q000209:etiology* / Q000503:physiopathology; D007263:Infusions, Parenteral / Q000009:adverse effects; D007430:Intraoperative Care / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D000077150:Oxaliplatin; D012189:Retrospective Studies; D012964:Sodium / Q000378:metabolism; D014882:Water-Electrolyte Balance
chemical_list: D000970:Antineoplastic Agents; D001786:Blood Glucose; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D012964:Sodium