Published in:
01-08-2008 | Correspondence
Extracorporeal membrane oxygenation rescue for cardiopulmonary collapse secondary to pheochromocytoma: report of three cases
Published in: Intensive Care Medicine | Issue 8/2008
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Sir: Pheochromocytomas are rare tumors with 0.2% prevalence among hypertensive patients [1]. Unusual presentations of pheochromocytoma, such as circulatory collapse [2], are even rarer and difficult to diagnose and rescue. The circulatory collapse often requires mechanical support bridging until recovery or cardiac transplantation [3]. Here we report three cases of profound cardiogenic shock rescued by extracorporeal membrane oxygenation (ECMO) and subsequently found to have pheochromocytoma. The clinical data are summarized in Table 1.
Table 1
Summary of the three cases with cardiogenic shock secondary to pheochromocytoma rescued by extracorporeal membrane oxygenation. ECHO, echocardiography; ECMO-CPR, extracorporeal membrane oxygenation used for cardiopulmonary resuscitation; LVEF, left ventricular ejection fraction; NA, not assessed; VMA, vanyllic mandelic acid
|
Case 1
|
Case 2
|
Case 3
|
|
|---|---|---|---|
|
Gender
|
Female
|
Male
|
Male
|
|
Age (year)
|
25
|
42
|
41
|
|
ECMO-CPR
|
Yes
|
No
|
Yes
|
|
ECMO duration (h)
|
57
|
163
|
45
|
|
24-h urine (mg/24 h)
|
|||
|
VMA
|
15.3
|
20.7
|
NA
|
|
Norepinephrine
|
28.3
|
858.0
|
NA
|
|
Epinephrine
|
51.0
|
1,876.0
|
NA
|
|
Dopamine
|
< 18
|
6,190
|
NA
|
|
Size and site of pheochromocytoma
|
46 × 43 mm; left adrenal
|
35 × 27 mm; left adrenal
|
60 × 60 mm; right adrenal
|
|
LVEF (%) at last ECHO follow-up
|
75
|
67
|
67
|
|
Current NYHA Fc
|
I
|
I
|
I
|