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Pheochromocytoma, Fulminant Heart Failure, and a Phenylephrine Challenge. The Perioperative Management of Adrenalectomy in a Jehovah’s Witness Patient: A Case Report Cover

Pheochromocytoma, Fulminant Heart Failure, and a Phenylephrine Challenge. The Perioperative Management of Adrenalectomy in a Jehovah’s Witness Patient: A Case Report

The Journal of Critical Care Medicine
Volume 8 (2022): Issue 1 (January 2022)
By: Sarah A. Bachman,  Ryan S. Peterson,  Peter S. Burrage and  Leigh C Hickerson  
Open Access
|Nov 2021

Figures & Tables

Fig. 1

Hemodynamic fluctuations during hospitalization. Time markers for initiation of beta blockade and surgery are superimposed.

Perioperative goals for pheochromocytoma, stress cardiomyopathy, and acute decompensated heart failure [19]

PheochromocytomaStress CardiomyopathyADHF
PreoperativeAlpha BlockadeAfterload reductionAfterload reduction
OptimizationAntiarrhythmicAntiarrhythmicAntiarrhythmic/ICD
Volume loadingDiureticsDiuretics
Beta BlockadeBeta blockade/ACEI (chronicBeta blockade/ACEI (chronic
stage/recovery) MCSstage/recovery) MCS
IntraoperativeAfterload reduction Vol-Afterload reductionMaintain cardiac output
Hemodynamic Goalsume resuscitationAvoid volume overloadAvoid volume overload
Expected Recovery10 days - 6 weeks1-4 weeksChronic, progressive
DOI: https://doi.org/10.2478/jccm-2021-0038 | Journal eISSN: 2393-1817 | Journal ISSN: 2393-1809
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Language: English
Page range: 55 - 60
Submitted on: Apr 6, 2021
|
Accepted on: Oct 10, 2021
|
Published on: Nov 13, 2021
Published by: University of Medicine, Pharmacy, Science and Technology of Targu Mures
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
pheochromocytoma,
systolic heart failure,
stress cardiomyopathy,
vasoplegia,
bloodless medical and surgical procedures
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Internal medicine, other,
Surgery,
Surgery, other,
Anaesthesiology,
Emergency medicine and intensive-care medicine

© 2021 Sarah A. Bachman, Ryan S. Peterson, Peter S. Burrage, Leigh C Hickerson, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution 4.0 License.

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