Lactic Acidosis during Anesthesia for Glioblastoma Multiforme Resection: The Warburg Effect
Journal Title: Enliven: Journal of Anesthesiology and Critical Care Medicine - Year 2017, Vol 4, Issue 2
Abstract
Background: The purpose of this case report is to present a case of significant lactic acidosis without clinical evidence of hypoperfusion, and show that it is likely due to lactic acid production by the brain tumor glioblastoma multiforme (GBM), the so-called Warburg Effect. Methods: Observational Methods (vitals and lab tests conducted) were conducted for a 57 year old female. Results: Final pathologic report of the tumor was recurrent GBM and therapy related changes. Hyperlactatemia and chronic lactic acidosis were attributed to her brain tumor as a diagnosis of exclusion. Conclusion: Lactic acidosis due to the Warburg Effect was a diagnosis of exclusion, and coupled with the patients’ hyperchloremic metabolic acidosis, caused a significant metabolic acidosis. Although perioperative lactic acidosis, however mild, is usually a marker for tissue hypoperfusion and/or cellular hypoxia, the anesthesiologist must be aware of the wider differential diagnosis including drugs, thiamine deficiency, and tumor based lactate production.
Authors and Affiliations
Mazhar Farhan, M. Rothenberg David
Keywords
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