Abstract
The administration of hyperthermic intraperitoneal chemotherapy (HIPEC) is often associated with significant intraoperative electrolyte changes. We retrospectively examined the pre-HIPEC and post-HIPEC intraoperative basic metabolic panel (BMP) values of the 20 patients who underwent HIPEC at our institution between December 2009 and January 2012. For the five patients who underwent HIPEC with oxaliplatin in 5% dextrose in water (D5W), there were statistically significant changes between the pre- and post-HIPEC values of sodium (135 to 124 mmol/L), chloride (105 to 94 mmol/L), glucose (143 to 388 mg/dl) and sodium corrected for hyperglycemia (135 to 127 mmol/L). For the 14 patients who received HIPEC with mitomycin C in normal saline (NS), there were statistically significant changes in bicarbonate (24 to 21 meQ/L), blood urea nitrogen (BUN) (10 to 9 mg/dl) and glucose (158 to 134 mg/dl). The BMP changes for the one patient who received doxorubicin/cisplatin in peritoneal dialysate are reported separately.
Highlights
Cytoreductive reductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) is playing an increasingly important role in the treatment of patients with peritoneal malignancies
With respect to intraoperative electrolyte disturbances, we found HIPEC with oxaliplatin in D5W to be associated with significant hyperglycemia and hyponatremia
Oxaliplatin for HIPEC is given at 460 mg/m2, and the degrees of hyperglycemia and hyponatremia we observed at this dose are similar to other reports [5]
Summary
Cytoreductive reductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) is playing an increasingly important role in the treatment of patients with peritoneal malignancies. How to cite this paper: Raytis, J.L. and Lew, M.W. (2014) Hyperthermic Intraperitoneal Chemotherapy (HIPEC) and Intraoperative Electrolyte Disturbances—Implications for Anesthetic Management. Cytoreductive surgery with HIPEC often involves an extensive surgical procedure that can present multiple intraoperative challenges to the anesthesiologist [4]. The administration of HIPEC can be associated with significant intraoperative electrolyte disturbances. Intervention by the anesthesiologist is often necessary, and readiness to appropriately treat the electrolyte disturbances associated with HIPEC facilitates the delivery of optimal anesthetic care. We set out to characterize the electrolyte disturbances seen in patients at our institution undergoing HIPEC with different chemotherapy agents
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