title: Perioperative sequential monitoring of hemodynamic parameters in patients with pheochromocytoma using the Non-Invasive Cardiac System (NICaS).
abstract: Surgical treatment of pheochromocytoma is associated with a high risk of hemodynamic instability. To reduce the risk of perioperative complications, adequate medical treatment to normalize blood pressure and restore blood volume is required. Accurate evaluation of the circulating blood volume (CBV) in perioperative patients with pheochromocytoma is clinically important. In the present study, we adopted whole-body bioimpedance monitoring technique using the Non-Invasive Cardiac System (NICaS), which can non-invasively measure cardiac output (CO) values. NICaS-derived CO values were evaluated in eight preoperative patients with pheochromocytoma and were compared with simultaneous CBV values measured by a conventional indicator dilution method using (131)I-labeled human serum albumin. In these patients with pheochromocytoma, the NICaS-derived CO values were significantly correlated with the CBV values measured by (131)I-labeled human serum albumin (4.86 ± 1.05 L/min vs 4.79 ± 1.02 L; r = 0.906; P = 0.002). Sequential NICaS-derived CO values confirmed that CBV increased after preoperative treatment with an α-blocker, with or without volume loading. The results of this study indicate that NICaS can be used to accurately and non-invasively evaluate the hemodynamic status. By sequential monitoring of NICaS-derived CO values, we are able to confirm whether adequate CBV in a patient with pheochromocytoma is obtained by preoperative medical treatment with α-blockers or volume loading, to avoid perioperative complications.
authors.affiliation: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Matsuda
authors.forename: Hisaya
authors.initials: H
authors.lastname: Kawate
authors.forename: Shingo
authors.initials: S
authors.lastname: Shimada
authors.forename: Chitose
authors.initials: C
authors.lastname: Matsuzaki
authors.forename: Hiromi
authors.initials: H
authors.lastname: Nagata
authors.forename: Masahiro
authors.initials: M
authors.lastname: Adachi
authors.forename: Keizo
authors.initials: K
authors.lastname: Ohnaka
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Nomura
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Takayanagi
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D017292:Doxazosin / Q000627:therapeutic use; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000379:methods*; D059035:Perioperative Period; D010673:Pheochromocytoma / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery*
chemical_list: D000959:Antihypertensive Agents; D017292:Doxazosin