| Severe Metabolic Acidosis during Intraperitoneal Hyperthermic Perfusion in Recurrent Ovarian Cancer: Case report. |
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Keon Hee Ryu, Dong Eon Moon, Hyeon Ja Kil, Young Cheol Kim |
1Department of Anesthesiology, College of Medicine, Catholic University, Seoul, Korea.
2Department of General Surgery, Ajou University of School of Medicine, Suwon, Korea. |
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| Abstract |
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Intraperitoneal hyperthermic perfusion(IPHP) was performed under combined epidural & general anesthesia in 57 year old female patient with recurrent ovarian cancer. She had past history of diabetes mellitus. Metabolic acidosis & hypokalemia were already developed before IPHP and aggravated during IPHP. NaHCO3 300mEq & KCl 40mEq were administered intravenously for three hours. In this case, we deduced that the causes of metabolic acidosis may be anaerobic glycolysis due to peripheral circulatory impairment from hypothermia, degradation of tumor cells by hyperthermia, and poor general condition with prolonged operation. The causes of hypokalemia were suspected to be continuous infusion of regular insulin, massive NaHCO3 administration, and diabetic ketoacidosis. Therefore, we recommend when performing IPHP in DM patient, precise preoperative evaluation and careful monitoring of arterial blood gas & electrolyte. |
| Key Words:
Acid-Base Equilibrium; metabolic acidosis; Hyperthermia; intraperitoneal hyperthermic perfusion |
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