Mechanical circulatory support such as extracorporeal membrane oxygenation is indicated in phaeochromocytoma crisis with sustained hypotension

Whitelaw, Ben; Prague, Julia; Mustafa, Omar G

doi:10.7861/clinmedicine.19-1-91b

Cited by 1 publication

(1 citation statement)

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“…Sustained intraoperative hypotension, which is associated with acute kidney injury, myocardial injury, and 30-day mortality, can persist until the postoperative period [3]. Postoperative prolonged hypotension puts patients at an increased risk of major morbidities and even death [4][5][6]. The rate of postoperative hypotension ranges from 10 to 50% in patients with PPGLs [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Risk Predictors of Prolonged Hypotension After Open Surgery for Pheochromocytomas and Paragangliomas

Kong

Tian

et al. 2020

World j. surg.

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Background Prolonged hypotension is a common complication after surgery for pheochromocytomas and paragangliomas (PPGLs). It places patients at an increased risk of major morbidities and even death. The objective of the study was to investigate the risk predictors of prolonged hypotension in patients undergoing open surgery for PPGLs. Methods The present study adopted a retrospective, single-center design. Patients who underwent open surgery for PPGLs were enrolled from January 1, 2002, to December 31, 2018, at Peking University First Hospital. Perioperative variables were screened from patients' electronic medical records. Prolonged hypotension was defined as hypotension that required continuous catecholamine support for at least 30 min to maintain a systolic blood pressure of [ 90 mmHg after surgery. Results A total of 162 patients were included in the study. Fifty-two patients (31.1%) had prolonged hypotension with a median vasopressor support duration of 14 h (IQR = 4-30 h). Body mass index\24 kg/m 2 (OR = 3.015, 95% CI 1.217-7.467; P = 0.017), larger tumor size (OR = 1.146, 95% CI 1.014-1.295; P = 0.029), and higher plasma norepinephrine concentration (OR = 1.053, 95% CI 1.019-1.087; P = 0.002) were associated with prolonged hypotension. Patients with prolonged hypotension had a higher incidence of complication, were more frequently admitted to the intensive care unit, underwent mechanical ventilation for a longer duration, and had a longer postoperative hospital stay when compared to those without. Conclusion Body mass index \ 24 kg/m 2 , larger tumor size, and higher plasma norepinephrine concentration are independent risk predictors of prolonged hypotension in patients undergoing open surgery for PPGLs.

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