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Severe hyponatremia, hyperglycemia, and hyperlactatemia are associated with intraoperative hyperthermic intraperitoneal chemoperfusion with oxaliplatin

Filip De Somer (UGent) , Wim Ceelen (UGent) , Joris Delanghe (UGent) , Dirk De Smet (UGent) , MARTIN VANACKERE (UGent) , Piet Pattyn (UGent) and Eric Mortier (UGent)
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Abstract
Background: Since the introduction of surgical debulking in combination with intraoperative hyperthermic intraperitoneal chemoperfusion (HIPEC) with oxaliplatin in our institution, severe hyponatremia (sodium: 126.5 +/- 3.8 mmol/L), hyperglycemia (glucose: 22.37 +/- 4.89 mmol/L), and hyperlactatemia (lactate: 3.17 +/- 1.09 mmol/L) have been observed post HIPEC. This metabolic disorder was not observed in patients in whom cisplatin or mitomycin C was used as a chemotherapeutic drug. Methods: In order to understand the pathophysiology of this finding, an analysis of our data was made. In a first analysis, plasma sodium was corrected for hyperglycemia based on the formula of Hillier. In a second analysis, the influence of total exchangeable sodium, total exchangeable potassium, and total body water on plasma sodium concentration was modeled. Results: Analysis of our data revealed a double mechanism for the observed metabolic disorder: hyperglycemia caused by dextrose 5%, which is used as a carrier for the oxaliplatin, and major loss of sodium into the dialysate (256.7 +/- 68.7 mmol). Conclusion: Better control of hyperglycemia and intravenous compensation of sodium loss into the dialysate can attenuate the reported biochemical disturbance.
Keywords
POTASSIUM, oxaliplatin, SODIUM CONCENTRATION, CHLORIDE, hyperthermic intraperitoneal chemoperfusion, metabolic disorder

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Chicago
De Somer, Filip, Wim Ceelen, Joris Delanghe, Dirk De Smet, MARTIN VANACKERE, Piet Pattyn, and Eric Mortier. 2008. “Severe Hyponatremia, Hyperglycemia, and Hyperlactatemia Are Associated with Intraoperative Hyperthermic Intraperitoneal Chemoperfusion with Oxaliplatin.” Peritoneal Dialysis International 25 (1): 61–66.
APA
De Somer, F., Ceelen, W., Delanghe, J., De Smet, D., VANACKERE, M., Pattyn, P., & Mortier, E. (2008). Severe hyponatremia, hyperglycemia, and hyperlactatemia are associated with intraoperative hyperthermic intraperitoneal chemoperfusion with oxaliplatin. PERITONEAL DIALYSIS INTERNATIONAL, 25(1), 61–66.
Vancouver
1.
De Somer F, Ceelen W, Delanghe J, De Smet D, VANACKERE M, Pattyn P, et al. Severe hyponatremia, hyperglycemia, and hyperlactatemia are associated with intraoperative hyperthermic intraperitoneal chemoperfusion with oxaliplatin. PERITONEAL DIALYSIS INTERNATIONAL. 2008;25(1):61–6.
MLA
De Somer, Filip, Wim Ceelen, Joris Delanghe, et al. “Severe Hyponatremia, Hyperglycemia, and Hyperlactatemia Are Associated with Intraoperative Hyperthermic Intraperitoneal Chemoperfusion with Oxaliplatin.” PERITONEAL DIALYSIS INTERNATIONAL 25.1 (2008): 61–66. Print.
@article{523030,
  abstract     = {Background: Since the introduction of surgical debulking in combination with intraoperative hyperthermic intraperitoneal chemoperfusion (HIPEC) with oxaliplatin in our institution, severe hyponatremia (sodium: 126.5 +/- 3.8 mmol/L), hyperglycemia (glucose: 22.37 +/- 4.89 mmol/L), and hyperlactatemia (lactate: 3.17 +/- 1.09 mmol/L) have been observed post HIPEC. This metabolic disorder was not observed in patients in whom cisplatin or mitomycin C was used as a chemotherapeutic drug.
Methods: In order to understand the pathophysiology of this finding, an analysis of our data was made. In a first analysis, plasma sodium was corrected for hyperglycemia based on the formula of Hillier. In a second analysis, the influence of total exchangeable sodium, total exchangeable potassium, and total body water on plasma sodium concentration was modeled.
Results: Analysis of our data revealed a double mechanism for the observed metabolic disorder: hyperglycemia caused by dextrose 5%, which is used as a carrier for the oxaliplatin, and major loss of sodium into the dialysate (256.7 +/- 68.7 mmol).
Conclusion: Better control of hyperglycemia and intravenous compensation of sodium loss into the dialysate can attenuate the reported biochemical disturbance.},
  author       = {De Somer, Filip and Ceelen, Wim and Delanghe, Joris and De Smet, Dirk and VANACKERE, MARTIN and Pattyn, Piet and Mortier, Eric},
  issn         = {0896-8608},
  journal      = {PERITONEAL DIALYSIS INTERNATIONAL},
  keywords     = {POTASSIUM,oxaliplatin,SODIUM CONCENTRATION,CHLORIDE,hyperthermic intraperitoneal chemoperfusion,metabolic disorder},
  language     = {eng},
  number       = {1},
  pages        = {61--66},
  title        = {Severe hyponatremia, hyperglycemia, and hyperlactatemia are associated with intraoperative hyperthermic intraperitoneal chemoperfusion with oxaliplatin},
  volume       = {25},
  year         = {2008},
}

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