Hyperthermic Intraperitoneal Chemotherapy (HIPEC) and Intraoperative Electrolyte Disturbances—Implications for Anesthetic Management

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.

Share and Cite:

Raytis, J. and Lew, M. (2014) Hyperthermic Intraperitoneal Chemotherapy (HIPEC) and Intraoperative Electrolyte Disturbances—Implications for Anesthetic Management. Open Journal of Anesthesiology, 4, 240-243. doi: 10.4236/ojanes.2014.410036.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Cashin, P.H., Graf, W., Nygren, P. and Mahteme, H. (2012) Intraoperative Hyperthermic Versus Postoperative Normothermic Intraperitoneal Chemotherapy for Colonic Peritoneal Carcinomatosis: A Case-Control Study. Annals of Oncology, 3, 647-652.
http://dx.doi.org/10.1093/annonc/mdr301
[2] Elias, D., Lefevre, J.H., Chevalier, J., Brouquet, A., Marchal, F., Classe, J.M., et al. (2009) Complete Cytoreductive Surgery plus Intraperitoneal Chemohyperthermia with Oxaliplatin for Peritoneal Carcinomatosis of Colorectal Origin. Journal of Clinical Oncology, 5, 681-685.
http://dx.doi.org/10.1200/JCO.2008.19.7160
[3] Zhu, Z.G., Tang, R., Yan, M., Chen, J., Yang, Q.M., Li, C., et al. (2006) Efficacy and Safety of Intraoperative Peritoneal Hyperthermic Chemotherapy for Advanced Gastric Cancer Patients with Serosal Invasion. Digestive Surgery, 23, 93-102.
http://dx.doi.org/10.1159/000093778
[4] Schmidt, C., Creutzenberg, M., Piso, P., Hobbhahn, J. and Bucher, M. (2008) Perioperative Anesthetic Management of Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy. Anaesthesia, 63, 389-395.
http://dx.doi.org/10.1111/j.1365-2044.2007.05380.x
[5] Rueth, N.M., Murray, S.E., Huddleston, S.J., Abbott, A.M., Greeno, E.W., Kirstein, M.N., et al. (2011) Severe Electrolyte Disturbances after Hyperthermic Intraperitoneal Chemotherapy: Oxaliplatin Virus Mitomycin C. Annals of Surgical Oncology, 18, 174-180.
http://dx.doi.org/10.1245/s10434-010-1210-1
[6] Song, E.C., Chu, K., Jeong, S.W., Jung, K.H., Kim, S.H., Kim, M. and Yoon, B.W. (2003) Hyperglycemia Exacerbates Brain Edema and Perihematomal Cell Death after Intracerebral Hemorrhage. Stroke, 34, 2215-2220.
http://dx.doi.org/10.1161/01.STR.0000088060.83709.2C
[7] Sharma, H.S. (2006) Hyperthermia Induced Brain Oedema: Current Status and Future Prespectives. Indian Journal of Medical Research, 123, 629-652.

Copyright © 2022 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.