Preoperative Factors Associated with Intraoperative Maximum Arterial Pressures in Patients with Pheochromocytoma and Paraganglioma.

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM International Journal of Endocrinology and Metabolism Pub Date : 2022-07-03 eCollection Date: 2022-07-01 DOI:10.5812/ijem-123114
Haruyuki Ohsugi, Nae Takizawa, Hidefumi Kinoshita
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引用次数: 2

Abstract

Background: Surgery for pheochromocytoma and paraganglioma (PPGL) can lead to life-threatening complications, such as intraoperative hypertensive crises, even when adequate doses of preoperative α-receptor blockades are administered.

Objectives: The aim of this study was to identify preoperative factors associated with intraoperative maximum arterial pressure (AP) in patients with PPGL.

Methods: We retrospectively reviewed the cases of 61 PPGL patients who underwent surgical resection in our hospital between 2006 and 2020. The primary outcome was intraoperative maximum AP as a single index for continuous variables. Simple and multiple linear regression model were used for statistical analysis.

Results: The median maximum systolic AP during surgery was 165 mmHg (interquartile range: 150 - 180 mmHg). Log24-h urinary-fractionated metanephrine (MN) and normetanephrine (NMN) was correlated with intraoperative maximum AP (R-squared = 0.218, P < 0.001). Multiple regression analyses showed that diabetes mellitus, one or more of the classic triad, and log24-h urinary-fractionated MN and NMN were independent factors associated with intraoperative maximum AP.

Conclusions: Patients with PPGL accompanied by diabetes mellitus, one or more of the classic triad, and high log 24-h urinary-fractionated MN and NMN values may be at risk for hypertensive crises during surgery regardless of whether preoperative α-receptor blockades are used. Clinicians should manage these patients more carefully and effectively.

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嗜铬细胞瘤和副神经节瘤患者术中最大动脉压的术前影响因素。
背景:手术治疗嗜铬细胞瘤和副神经节瘤(PPGL)可导致危及生命的并发症,如术中高血压危象,即使术前给予足够剂量的α-受体阻断。目的:本研究的目的是确定与PPGL患者术中最高动脉压(AP)相关的术前因素。方法:回顾性分析2006年至2020年在我院行手术切除的61例PPGL患者。主要结果是术中最大AP作为连续变量的单一指标。采用简单线性回归模型和多元线性回归模型进行统计分析。结果:术中最大收缩压中位数为165 mmHg(四分位数范围:150 - 180 mmHg)。log24 h尿分离肾上腺素(MN)和去甲肾上腺素(NMN)与术中最大AP相关(r²= 0.218,P < 0.001)。多元回归分析显示,糖尿病、经典三联征中的一种或多种、log24-h尿分MN和NMN是影响术中最大ap的独立因素。结论:PPGL合并糖尿病、经典三联征中的一种或多种、高log24-h尿分MN和NMN值的患者,无论术前是否使用α-受体阻断剂,术中均有发生高血压危重的危险。临床医生应该更仔细、更有效地管理这些患者。
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来源期刊
CiteScore
3.10
自引率
4.80%
发文量
0
期刊介绍: The aim of the International Journal of Endocrinology and Metabolism (IJEM) is to increase knowledge, stimulate research in the field of endocrinology, and promote better management of patients with endocrinological disorders. To achieve this goal, the journal publishes original research papers on human, animal and cell culture studies relevant to endocrinology.
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