Hydroxocobalamin to treat refractory vasoplegia following phaeochromocytoma resection in a child.
Andrew J GiustiniE V RoweFelipe D PerezFrederick MihmPublished in: Anaesthesia reports (2022)
Phaeochromocytomas and paragangliomas are rare neuroendocrine tumours that often secrete catecholamines, which can cause dramatic swings in blood pressure and end-organ damage. During surgical resection of these tumours, antihypertensive drug infusions are often required, but after resection patients may become vasoplegic, in part due to cessation of catecholamine secretion by the tumour in the context of pre-operative α 1 adrenoceptor antagonism. Numerous medications have been used to treat vasoplegia in this setting, including noradrenaline, vasopressin and, more recently, angiotensin II. We report the case of a patient who experienced vasoplegia after phaeochromocytoma resection which was refractory to vasopressin and angiotensin II infusions but was successfully treated with high dose hydroxocobalamin.
Keyphrases
- angiotensin ii
- blood pressure
- angiotensin converting enzyme
- vascular smooth muscle cells
- high dose
- end stage renal disease
- newly diagnosed
- ejection fraction
- hypertensive patients
- low dose
- peritoneal dialysis
- mental health
- case report
- emergency department
- patient reported outcomes
- metabolic syndrome
- adverse drug
- weight loss