Severe metabolic acidosis secondary to iatrogenic hyperglycaemia in secondary cytoreduction and hyperthermic intraperitoneal chemotherapy (HiPEC).

Doxorubicin causes insulin resistance and hyperglycaemia by disrupting adenosine monophosphate activated protein kinase (AMPK) signaling pathways.[ 5 ] Haemodynamic instability (not requiring ionotropic support) during secondary cytoreduction owing to blood loss and massive fluid shifts lead to metabolic acidosis, which was exaggerated during HiPEC with a decreasing trend in pH and bicarbonate [ Table 1 ].

also in 47,180 other papers