Continuous blood purification in patients with pheochromocytoma crisis: A case report
Key Clinical Message Pheochromocytoma crisis accompanied by multi‐organ failure necessitates prompt and comprehensive interventions, including VA‐ECMO, CRRT, and others. Successful laparoscopic tumor resection promotes favorable outcomes and recovery. Abstract Pheochromocytoma crisis is commonly ass...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-10-01
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| Series: | Clinical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ccr3.8036 |
| _version_ | 1797650390311763968 |
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| author | Meinong Zhong Yuanqiang Zhu Shaofang Wang Hengying Fang Guili Chen |
| author_facet | Meinong Zhong Yuanqiang Zhu Shaofang Wang Hengying Fang Guili Chen |
| author_sort | Meinong Zhong |
| collection | DOAJ |
| description | Key Clinical Message Pheochromocytoma crisis accompanied by multi‐organ failure necessitates prompt and comprehensive interventions, including VA‐ECMO, CRRT, and others. Successful laparoscopic tumor resection promotes favorable outcomes and recovery. Abstract Pheochromocytoma crisis is commonly associated with high mortality, high surgical risk, and rapidly fatal complications. This article presented successful treatments and nursing experiences in a patient with pheochromocytoma who developed cardiogenic shock and multiple organ failure. We report a case study of a 32‐year‐old female patient who experienced pheochromocytoma crisis accompanied by multiple organ failure. Initial assessment of bedside echocardiography revealed an extremely low left ventricular ejection fraction of 8%. The patient was promptly resuscitated though tracheal intubation and venoarterial extracorporeal membrane oxygenation (VA‐ECMO), in conjunction with continuous renal replacement therapy (CRRT), alpha‐blockers, beta‐blockers, and other pharmacological interventions to manage blood pressure and heart rate. These interventions resulted in a remarkable increase in the left ventricular ejection fraction of 67%. However, the patient subsequently developed severe sepsis, which may have been caused by the intubation procedure, necessitating the discontinuation of VA‐ECMO while maintaining CRRT. Close monitoring of plasma catecholamine metabolite level, hemodynamic index, inflammatory marker, liver and kidney functions, and electrolytes during CRRT support allows for evaluating the efficacy of these measures and assessing the impact of CRRT on pheochromocytoma crisis. Eventually, the patient successfully underwent laparoscopic resection of a large pheochromocytoma, leading to favorable prognosis and a successful recovery. Continuous blood purification therapy can effectively eliminate catecholamines and their byproducts from the plasma, stabilize hemodynamics, improve heart, liver, and kidney functions, significantly reduce inflammatory cytokine levels significantly, and extend the surgical window for patients. |
| first_indexed | 2024-03-11T15:59:35Z |
| format | Article |
| id | doaj.art-1c362e3fdf9b4c89acb931bcf49f4b76 |
| institution | Directory Open Access Journal |
| issn | 2050-0904 |
| language | English |
| last_indexed | 2024-03-11T15:59:35Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj.art-1c362e3fdf9b4c89acb931bcf49f4b762023-10-25T07:12:45ZengWileyClinical Case Reports2050-09042023-10-011110n/an/a10.1002/ccr3.8036Continuous blood purification in patients with pheochromocytoma crisis: A case reportMeinong Zhong0Yuanqiang Zhu1Shaofang Wang2Hengying Fang3Guili Chen4Division of Urology The Third Affiliated Hospital of Sun Yat‐Sen University Guangzhou ChinaDivision of Urology The Third Affiliated Hospital of Sun Yat‐Sen University Guangzhou ChinaInternal Medicine Intensive Care Unit The Third Affiliated Hospital of Sun Yat‐Sen University Guangzhou ChinaDepartment of Nursing The Third Affiliated Hospital of Sun Yat‐sen University Guangzhou ChinaDivision of Urology The Third Affiliated Hospital of Sun Yat‐Sen University Guangzhou ChinaKey Clinical Message Pheochromocytoma crisis accompanied by multi‐organ failure necessitates prompt and comprehensive interventions, including VA‐ECMO, CRRT, and others. Successful laparoscopic tumor resection promotes favorable outcomes and recovery. Abstract Pheochromocytoma crisis is commonly associated with high mortality, high surgical risk, and rapidly fatal complications. This article presented successful treatments and nursing experiences in a patient with pheochromocytoma who developed cardiogenic shock and multiple organ failure. We report a case study of a 32‐year‐old female patient who experienced pheochromocytoma crisis accompanied by multiple organ failure. Initial assessment of bedside echocardiography revealed an extremely low left ventricular ejection fraction of 8%. The patient was promptly resuscitated though tracheal intubation and venoarterial extracorporeal membrane oxygenation (VA‐ECMO), in conjunction with continuous renal replacement therapy (CRRT), alpha‐blockers, beta‐blockers, and other pharmacological interventions to manage blood pressure and heart rate. These interventions resulted in a remarkable increase in the left ventricular ejection fraction of 67%. However, the patient subsequently developed severe sepsis, which may have been caused by the intubation procedure, necessitating the discontinuation of VA‐ECMO while maintaining CRRT. Close monitoring of plasma catecholamine metabolite level, hemodynamic index, inflammatory marker, liver and kidney functions, and electrolytes during CRRT support allows for evaluating the efficacy of these measures and assessing the impact of CRRT on pheochromocytoma crisis. Eventually, the patient successfully underwent laparoscopic resection of a large pheochromocytoma, leading to favorable prognosis and a successful recovery. Continuous blood purification therapy can effectively eliminate catecholamines and their byproducts from the plasma, stabilize hemodynamics, improve heart, liver, and kidney functions, significantly reduce inflammatory cytokine levels significantly, and extend the surgical window for patients.https://doi.org/10.1002/ccr3.8036cardiogenic shockcase reportcontinuous blood purification therapyefficacymultiple organ dysfunctionpheochromocytoma crisis |
| spellingShingle | Meinong Zhong Yuanqiang Zhu Shaofang Wang Hengying Fang Guili Chen Continuous blood purification in patients with pheochromocytoma crisis: A case report Clinical Case Reports cardiogenic shock case report continuous blood purification therapy efficacy multiple organ dysfunction pheochromocytoma crisis |
| title | Continuous blood purification in patients with pheochromocytoma crisis: A case report |
| title_full | Continuous blood purification in patients with pheochromocytoma crisis: A case report |
| title_fullStr | Continuous blood purification in patients with pheochromocytoma crisis: A case report |
| title_full_unstemmed | Continuous blood purification in patients with pheochromocytoma crisis: A case report |
| title_short | Continuous blood purification in patients with pheochromocytoma crisis: A case report |
| title_sort | continuous blood purification in patients with pheochromocytoma crisis a case report |
| topic | cardiogenic shock case report continuous blood purification therapy efficacy multiple organ dysfunction pheochromocytoma crisis |
| url | https://doi.org/10.1002/ccr3.8036 |
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