<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Perioperative management of pheochromocytoma in the setting of catecholamine-induced heart failure requires careful consideration of hemodynamic optimization and possible mechanical circulatory support. A Jehovah’s Witness patient with catecholamine-induced acutely decompensated heart failure required dependable afterload reduction for a cardio-protective strategy. This was emphasized due to the relative contraindication to perioperative anticoagulation required for mechanical circulatory support. A phenylephrine challenge clearly demonstrated adequate alpha blockade after only 24 hours of phenoxybenzamine treatment. This resulted in advancement of the surgery date. This case also highlights management of beta blockade, volume and salt loading, autologous blood transfusion, and profound post-operative vasoplegia in the setting of cardiogenic shock. Careful attention to hemodynamic optimization and cardio-protective strategies ultimately resulted in positive outcome for this challenging clinical scenario.</p></abstract>

Perioperative management of pheochromocytoma in the setting of catecholamine-induced heart failure requires careful consideration of hemodynamic optimization and possible mechanical circulatory support. A Jehovah’s Witness patient with catecholamine-induced acutely decompensated heart failure required dependable afterload reduction for a cardio-protective strategy. This was emphasized due to the relative contraindication to perioperative anticoagulation required for mechanical circulatory support. A phenylephrine challenge clearly demonstrated adequate alpha blockade after only 24 hours of phenoxybenzamine treatment. This resulted in advancement of the surgery date. This case also highlights management of beta blockade, volume and salt loading, autologous blood transfusion, and profound post-operative vasoplegia in the setting of cardiogenic shock. Careful attention to hemodynamic optimization and cardio-protective strategies ultimately resulted in positive outcome for this challenging clinical scenario.

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

This work is licensed under the Creative Commons Attribution 4.0 International License.

Perioperative management of pheochromocytoma in the setting of catecholamine-induced heart failure requires careful consideration of hemodynamic optimization...

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

Article Category: Case report

Published Online: Nov 13, 2021

Page range: 55 - 60

Received: Apr 06, 2021

Accepted: Oct 10, 2021

DOI: https://doi.org/10.2478/jccm-2021-0038

Keywords
pheochromocytoma, systolic heart failure, stress cardiomyopathy, vasoplegia, bloodless medical and surgical procedures

© 2022 Sarah A. Bachman, Ryan S. Peterson, Peter S. Burrage, Leigh C Hickerson, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

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

Article Category: Case report

Published Online: Nov 13, 2021

Page range: 55 - 60

Received: Apr 06, 2021

Accepted: Oct 10, 2021

DOI: https://doi.org/10.2478/jccm-2021-0038

Keywordspheochromocytoma, systolic heart failure, stress cardiomyopathy, vasoplegia, bloodless medical and surgical procedures

© 2022 Sarah A. Bachman, Ryan S. Peterson, Peter S. Burrage, Leigh C Hickerson, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Keywords
pheochromocytoma, systolic heart failure, stress cardiomyopathy, vasoplegia, bloodless medical and surgical procedures