[Impact of the hyperthermic intraperitoneal chemotherapy on the fluid-electrolytes changes and on the acid-base balance].
Fiche publication
Date publication
octobre 2010
Auteurs
Membres identifiés du Cancéropôle Est :
Dr DESANDES Emmanuel, Pr MARCHAL Frédéric, Dr RAFT Julien
Tous les auteurs :
Raft J, Parisot M, Marchal F, Tala S, Desandes E, Lalot JM, Guillemin F, Longrois D, Meistelman C
Lien Pubmed
Résumé
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. CONCLUSION: 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.
Référence
Ann Fr Anesth Reanim. 2010 Oct;29(10):676-81