[Impact of the hyperthermic intraperitoneal chemotherapy on the fluid-electrolytes changes and on the acid-base balance].
BACKGROUND
Hyperthermic intraperitoneal chemoperfusion (HIPEC) is an innovative treatment of the peritoneal carcinomatosis with potential iatrogenicity. This observational study was designed to improve our understanding of HIPEC's impact on the renal and respiratory functions, on temperature, blood cells counts, body fluids/electrolytes and acid-base balance.


METHODS
We retrospectively analyzed the perioperative care of 20 patients that underwent HIPEC with oxaliplatin (n=19) and mitomycin C (n=1). The abdominal cavity was filled with the peritoneal dialysis fluid with dextrose 5%: volume of 2L/m(2). Follow-up for the study was stopped on postoperative day 7.


RESULTS
The main changes were appearing just after the HIPEC procedure: increased diuresis, lactic acidosis, hyponatremia and hyperglycaemia (despite aggressive intravenous insulin therapy). In our series, there was no renal failure or impact on blood cells counts until the 7(th) day, neither some changes on the arterial blood gases.


CONCLUSIONS
Hyperglycemia might explain increased diuresis of lactic acidosis and the rapid installation of hyponatremia. Taken together, these results suggest that glycemic control must be improved in order to avoid the other metabolic disturbances.
Raft
J
J
Centre Alexis-Vautrin, département d'anesthésie-réanimation, Nancy université, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France. j.raft@nancy.fnclcc.fr
Parisot
M
M
Marchal
F
F
Tala
S
S
Desandes
E
E
Lalot
J-M
JM
Guillemin
F
F
Longrois
D
D
Meistelman
C
C
D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001826:Body Fluids; D002277:Carcinoma / Q000188:drug therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy*; D010537:Peritoneum; D012189:Retrospective Studies; D014883:Water-Electrolyte Imbalance / Q000209:etiology*
D000970:Antineoplastic Agents