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Tumor Lysis Syndrome

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Evidence-Based Critical Care

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Abstract

Tumor lysis syndrome is an oncological emergency. The massive turnover of tumor cells leads to accumulation of electrolytes and uric acid that could lead to renal failure and cardiac arrhythmias. There are clinical and laboratory classifications of tumor lysis syndrome, and several risk stratification models have been proposed. Prevention of tumor lysis syndrome involves intravenous hydration and administration of hypouricemic agents. Rasburicase is preferred over allopurinol in high risk cases. Urinary alkalization in prevention is controversial. Treatment of tumor lysis syndrome includes intensive monitoring of renal function, fluid balance and electrolytes. Neuromuscular irritability manifesting as cardiac arrhythmias and seizures is a significant concern. Prevention of cardiac arrhythmias is done by appropriately managing hyperkalemia and hypocalcemia. Despite aggressive preventive measures, renal failure develops in some patients requiring initiation of renal replacement therapy. Pre-phase treatment with low intensity chemotherapy has been a strategy that is being used frequently in certain forms of cancer to reduce the development of tumor lysis syndrome. Certain aspects of management of tumor lysis syndrome remain controversial.

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Author information

Authors and Affiliations

  1. Division of Pulmonary, Critical Care, and Sleep Medicine, Geisinger Health, Danville, PA, USA

    Himaja Koneru

  2. Section of Pulmonary, Critical Care, and Sleep Medicine, Beaumont Health, Royal Oak, MI, USA

    Anil Pattisapu & Paul D. Bozyk

Authors
  1. Himaja Koneru
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  2. Anil Pattisapu
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  3. Paul D. Bozyk
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Corresponding author

Correspondence to Paul D. Bozyk .

Editor information

Editors and Affiliations

  1. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Robert C. Hyzy

  2. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Jakob McSparron

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Koneru, H., Pattisapu, A., Bozyk, P.D. (2020). Tumor Lysis Syndrome. In: Hyzy, R.C., McSparron, J. (eds) Evidence-Based Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-26710-0_81

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  • DOI: https://doi.org/10.1007/978-3-030-26710-0_81

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-26709-4

  • Online ISBN: 978-3-030-26710-0

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