Inability to alkalinize urine in a patient at risk for tumor lysis syndrome: a case report.
This report provides a description and discussion of a 19-year-old, 65-kg male, with a large mediastinal mass, right pleural effusion, and pericardial effusion, requiring urine alkalinization during a propofol infusion. The patient required NaHCO3 boluses, urine pH, electrolyte, arterial blood gas and lactate monitoring, and discontinuation of the propofol. The authors suggest that caution be used when prescribing a propofol infusion for patients who are at risk of tumor lysis syndrome and the need for urine alkalinization.
Steelman
Robert
R
Pediatric Critical Care Medicine and Oral and Maxillofacial Surgery, Oregon Health & Science University, Portland, Oregon 97239, USA.
Pate
Mary Frances D
MF
Shoun
Patricia
P
Wachtel
Kathleen
K
Johannes
Phyllis Winters
PW
D000328:Adult; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008479:Mediastinal Neoplasms / Q000628:therapy / Q000652:urine*; D010490:Pericardial Effusion / Q000628:therapy / Q000652:urine*; D016066:Pleural Effusion, Malignant / Q000628:therapy / Q000652:urine*; D015742:Propofol / Q000008:administration & dosage; D017693:Sodium Bicarbonate / Q000008:administration & dosage; D015275:Tumor Lysis Syndrome / Q000628:therapy / Q000652:urine*
D018686:Anesthetics, Intravenous; D017693:Sodium Bicarbonate; D015742:Propofol