Extracorporeal life support for phaeochromocytoma-induced cardiogenic shock: a systematic review

Matteo Matteucci*, Mariusz Kowalewski, Dario Fina, Federica Jiritano, Paolo Meani, Giuseppe M. Raffa, Ibrahim Aldobayyan, Cesare Beghi, Jos Maessen, Roberto Lorusso

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Web of Science)

Abstract

Introduction: Phaeochromocytoma is a catecholamine-secreting tumour associated with clinical presentation ranging from paroxysmal hypertension to intractable cardiogenic shock. Extracorporeal life support, in veno-arterial mode, application in refractory acute heart dysfunction is sharply increasing worldwide. However, its clinical utility in phaeochromocytoma-induced cardiogenic shock remains still unclear.

Methods: A systematic review of published reports was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement. Searches were accomplished on PubMed, Embase and Google Scholar to identify articles describing the use of extracorporeal life support in the setting of phaeochromocytoma-induced cardiogenic shock (PROSPERO: CRD42019125225).

Results: Thirty-five reports, including 62 patients supported with extracorporeal life support because of intractable phaeochromocytoma crisis, were included for the analysis. Almost all the subjects underwent peripheral cannulation for extracorporeal life support. The median duration of the mechanical circulatory support was 5days, and most of the patients recovered normal myocardial function (left ventricular ejection fraction 50%). In-hospital survival was 87%. Phaeochromocytoma was removed surgically during extracorporeal life support in 10 patients (16%), while in the remaining after haemodynamic stabilization and weaning from the mechanical support.

Conclusion: Successful management of phaeochromocytoma-induced cardiogenic shock depends on prompt recognition and immediate treatment of shock. In this scenario, extracorporeal life support may play a significant role allowing cardiac and end-organ recovery and giving time for accurate diagnosis and specific treatment.

Original languageEnglish
Pages (from-to)20-28
Number of pages9
JournalPerfusion
Volume35
DOIs
Publication statusPublished - May 2020
Event9th EuroELSO Congress - London, United Kingdom
Duration: 29 Mar 202131 Mar 2021

Keywords

  • extracorporeal life support
  • phaeochromocytoma
  • cardiogenic shock
  • mechanical circulatory support
  • ACUTE MYOCARDIAL-INFARCTION
  • LONG-TERM OUTCOMES
  • PERCUTANEOUS CARDIOPULMONARY SUPPORT
  • TAKOTSUBO-LIKE CARDIOMYOPATHY
  • MORTALITY RISK SCORE
  • MEMBRANE-OXYGENATION
  • FULMINANT MYOCARDITIS
  • ASSIST DEVICE
  • CRISIS
  • PATIENT

Cite this