Perioperative hemodynamic instability in pheochromocytoma and sympathetic paraganglioma patients

Abstract For pheochromocytoma and sympathetic paraganglioma (PPGL), surgery can be used as a curative treatment; however, the life-threatening risk of perioperative hemodynamic instability (HI) presents challenges. This study aimed to analyze the incidence and predictive factors of perioperative HI....

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Autores principales:	Jung Hee Kim, Hyung-Chul Lee, Su-jin Kim, Soo Bin Yoon, Sung Hye Kong, Hyeong Won Yu, Young Jun Chai, June Young Choi, Kyu Eun Lee, Kwang-Woong Lee, Seung-Kee Min, Chan Soo Shin, Kyu Joo Park
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fdbae0ae34174ffeb12be14881908011
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spelling	oai:doaj.org-article:fdbae0ae34174ffeb12be148819080112021-12-02T15:15:35ZPerioperative hemodynamic instability in pheochromocytoma and sympathetic paraganglioma patients10.1038/s41598-021-97964-32045-2322https://doaj.org/article/fdbae0ae34174ffeb12be148819080112021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-97964-3https://doaj.org/toc/2045-2322Abstract For pheochromocytoma and sympathetic paraganglioma (PPGL), surgery can be used as a curative treatment; however, the life-threatening risk of perioperative hemodynamic instability (HI) presents challenges. This study aimed to analyze the incidence and predictive factors of perioperative HI. The electronic medical records of 114 consecutive patients who underwent surgery for PPGLs at our institution were retrospectively reviewed. HI was defined as one or more episodes of systolic blood pressure > 200 mmHg or mean blood pressure < 60 mmHg during surgery. The factors predictive of perioperative HI were determined using both univariate and multivariate analyses. Intraoperative HI occurred in 79 (69.3%) patients. In multivariate analysis, α-adrenergic receptor blocker duration (days) (odds ratio, 1.015; 95% confidence interval, 1.001–1.029) was a predictor for intraoperative HI. Postoperative hypotension occurred in 36 (31.6%) patients. Higher urine epinephrine levels, and greater preoperative highest heart rate (HR) were predictive factors for postoperative hypotension in PPGL patients. Caution should be taken in perioperative management for PPGL, especially with long duration of α-adrenergic receptor blocker use, higher urine epinephrine levels, and greater preoperative highest HR.Jung Hee KimHyung-Chul LeeSu-jin KimSoo Bin YoonSung Hye KongHyeong Won YuYoung Jun ChaiJune Young ChoiKyu Eun LeeKwang-Woong LeeSeung-Kee MinChan Soo ShinKyu Joo ParkNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jung Hee Kim Hyung-Chul Lee Su-jin Kim Soo Bin Yoon Sung Hye Kong Hyeong Won Yu Young Jun Chai June Young Choi Kyu Eun Lee Kwang-Woong Lee Seung-Kee Min Chan Soo Shin Kyu Joo Park Perioperative hemodynamic instability in pheochromocytoma and sympathetic paraganglioma patients
description	Abstract For pheochromocytoma and sympathetic paraganglioma (PPGL), surgery can be used as a curative treatment; however, the life-threatening risk of perioperative hemodynamic instability (HI) presents challenges. This study aimed to analyze the incidence and predictive factors of perioperative HI. The electronic medical records of 114 consecutive patients who underwent surgery for PPGLs at our institution were retrospectively reviewed. HI was defined as one or more episodes of systolic blood pressure > 200 mmHg or mean blood pressure < 60 mmHg during surgery. The factors predictive of perioperative HI were determined using both univariate and multivariate analyses. Intraoperative HI occurred in 79 (69.3%) patients. In multivariate analysis, α-adrenergic receptor blocker duration (days) (odds ratio, 1.015; 95% confidence interval, 1.001–1.029) was a predictor for intraoperative HI. Postoperative hypotension occurred in 36 (31.6%) patients. Higher urine epinephrine levels, and greater preoperative highest heart rate (HR) were predictive factors for postoperative hypotension in PPGL patients. Caution should be taken in perioperative management for PPGL, especially with long duration of α-adrenergic receptor blocker use, higher urine epinephrine levels, and greater preoperative highest HR.
format	article
author	Jung Hee Kim Hyung-Chul Lee Su-jin Kim Soo Bin Yoon Sung Hye Kong Hyeong Won Yu Young Jun Chai June Young Choi Kyu Eun Lee Kwang-Woong Lee Seung-Kee Min Chan Soo Shin Kyu Joo Park
author_facet	Jung Hee Kim Hyung-Chul Lee Su-jin Kim Soo Bin Yoon Sung Hye Kong Hyeong Won Yu Young Jun Chai June Young Choi Kyu Eun Lee Kwang-Woong Lee Seung-Kee Min Chan Soo Shin Kyu Joo Park
author_sort	Jung Hee Kim
title	Perioperative hemodynamic instability in pheochromocytoma and sympathetic paraganglioma patients
title_short	Perioperative hemodynamic instability in pheochromocytoma and sympathetic paraganglioma patients
title_full	Perioperative hemodynamic instability in pheochromocytoma and sympathetic paraganglioma patients
title_fullStr	Perioperative hemodynamic instability in pheochromocytoma and sympathetic paraganglioma patients
title_full_unstemmed	Perioperative hemodynamic instability in pheochromocytoma and sympathetic paraganglioma patients
title_sort	perioperative hemodynamic instability in pheochromocytoma and sympathetic paraganglioma patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/fdbae0ae34174ffeb12be14881908011
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Perioperative hemodynamic instability in pheochromocytoma and sympathetic paraganglioma patients

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