N Azadeh1, H Ramakrishna2, N L Bhatia3, J C Charles4, F Mookadam5. 1. Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA. azadeh.natalya@mayo.edu. 2. Department of Anesthesia, Mayo Clinic, Phoenix, AZ, USA. 3. Cardiovascular Consultants, LTD, Glendale, AZ, USA. 4. Division of Hospital Internal Medicine, Mayo Clinic, Phoenix, AZ, USA. 5. Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ, USA.
Abstract
INTRODUCTION: Pheochromocytomas are rare neuroendocrine tumors of the adrenal medulla that may present with protean manifestations. Surgical resection is the mainstay of therapy and patients are at risk of significant hemodynamic and circulatory complications mainly attributable to catecholamine excess. The mainstay of medical therapy in order to optimize patients for surgery includes: alpha-blockers, beta-blockers, calcium channel blocker and other agents to achieve normal blood pressure, heart rate, as well as normal volume status. Understanding the pathophysiology of pheochromocytoma, the pharmacology of medications used, and recognizing postoperative complications will impact patient outcomes. CONCLUSION: A multidisciplinary team approach is best throughout the perioperative period to prevent potential complications that arise. The hospital physician, intensivist, anesthetist and cardiovascular specialist play a pivotal role in the management of patients with pheochromocytoma. In addition to the pharmacologic and volume recommendations, a multidisciplinary discussion allows for seamless implementation of an organized plan of care.
INTRODUCTION:Pheochromocytomas are rare neuroendocrine tumors of the adrenal medulla that may present with protean manifestations. Surgical resection is the mainstay of therapy and patients are at risk of significant hemodynamic and circulatory complications mainly attributable to catecholamine excess. The mainstay of medical therapy in order to optimize patients for surgery includes: alpha-blockers, beta-blockers, calcium channel blocker and other agents to achieve normal blood pressure, heart rate, as well as normal volume status. Understanding the pathophysiology of pheochromocytoma, the pharmacology of medications used, and recognizing postoperative complications will impact patient outcomes. CONCLUSION: A multidisciplinary team approach is best throughout the perioperative period to prevent potential complications that arise. The hospital physician, intensivist, anesthetist and cardiovascular specialist play a pivotal role in the management of patients with pheochromocytoma. In addition to the pharmacologic and volume recommendations, a multidisciplinary discussion allows for seamless implementation of an organized plan of care.
Authors: Alberto Mazza; Michela Armigliato; Maria Cristina Marzola; Laura Schiavon; Domenico Montemurro; Giorgio Vescovo; Marco Zuin; Sotirios Chondrogiannis; Roberta Ravenni; Giuseppe Opocher; Patrick M Colletti; Domenico Rubello Journal: Endocrine Date: 2013-07-02 Impact factor: 3.633
Authors: M Araujo-Castro; E Pascual-Corrales; L Nattero Chavez; A Martínez Lorca; T Alonso-Gordoa; J Molina-Cerrillo; J Lorca Álvaro; C Mínguez Ojeda; S Redondo López; R Barberá Durbán; R Polo López; N Moreno Mata; U Caballero Silva; H Pian; I Ruz-Caracuel; A Sanjuanbenito Dehesa; V Gómez Dos Santos; A B Serrano Romero Journal: J Endocrinol Invest Date: 2021-07-25 Impact factor: 4.256