Purpose:

In this article, we aimed to elaborate on perioperative and complication management in treatment of pheochromocytoma crisis with extracorporeal membrane oxygenation (ECMO).

Material and methods:

We report a case of relatively rare grant paraganglioma-induced pheochromocytoma crisis leading to severe circulatory failure, treated with venoarterial extracorporeal membrane oxygenation (V-A ECMO) as a bridge to curative adrenalectomy. Weaning of ECMO was followed by successful surgical removal of the tumor, and patient survival. However, distal ischemia of the cannulated leg occurred during ECMO operation, which eventually led to amputation. In addition, the patient developed new cerebral infarction and left hemiplegia, half a month after paraganglioma resection.

Conclusions:

We believe that patients with pheochromocytoma crisis, who cannot maintain blood circulation, are eligible for V-A ECMO treatment. Moreover, care should be taken to prevent thrombosis and individualized and precise blood pressure management targets. Early detection and treatment of thrombosis is imperative to long-term prognosis of patients with ECMO.

中文翻译：

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围手术期和并发症管理在静脉动脉体外膜肺氧合 (VA ECMO) 治疗嗜铬细胞瘤危象中的重要性：病例报告和文献复习

目的：

在本文中，我们旨在阐述体外膜肺氧合（ECMO）治疗嗜铬细胞瘤危象的围手术期和并发症处理。

材料与方法：

我们报告了一例相对罕见的由副神经节瘤引起的嗜铬细胞瘤危象导致严重循环衰竭的病例，该病例采用静脉动脉体外膜肺氧合 (VA ECMO) 作为治愈性肾上腺切除术的桥梁。撤除 ECMO 后，成功手术切除了肿瘤，患者得以存活。然而，在ECMO操作过程中，插管腿出现远端缺血，最终导致截肢。此外，患者在副神经节瘤切除后半个月出现新发脑梗塞和左侧偏瘫。

结论：

我们认为无法维持血液循环的嗜铬细胞瘤危象患者有资格接受 VA ECMO 治疗。此外，应注意预防血栓形成和个体化、精准的血压管理目标。血栓的早期发现和治疗对ECMO患者的长期预后至关重要。