Sauneuf et al reported their experience with the management of patients with pheochromocytoma who require intensive care during a crisis. The authors are from multiple institutions in France.
Patient selection: pheochromocytoma crisis
The ICU mortality rate high (24%).
Diagnosis can be challenging:
(1) when typical findings pheochromocytoma are absent
(2) if there is no previous history of pheochromocytoma
(3) if there is no family history of genetic risk
Early performance of abdominal CT should be considered in a patient with unexplained cardiogenic shock.
Management may require:
(1) mechanical ventilation
(2) vasoactive drug infusions
(3) renal replacement therapy
(4) excision of adrenal tumor as soon as possible.
(5) control of cardiac arrhythmias
For patients with a severe crisis:
(1) venoarterial ECMO can be lifesaving
(2) adrenalectomy may need to be performed urgently
