title: Adrenergic crisis due to pheochromocytoma - practical aspects. A short review.
abstract: BACKGROUND
  The definitive therapy in case of pheochromocytoma is complete surgical resection. Improper preoperative assessment and medical management generally places the patient at risk for complications, resulting from an adrenergic crisis. Therefore, it is crucial to adequately optimize these patients before surgery. Optimal preoperative medical management significantly decreases morbidity and mortality during the tumor resection.
  
  
  METHODS
  This review addresses current knowledge in pre- and intraoperative assessment of a patient with pheochromocytoma.
  
  
  RESULTS
  Before surgery the patient is conventionally prepared with α-adrenergic blockade (over 10-14 days) and subsequently, additional β-adrenergic blockade is required to treat any associated tachyarrhythmias. In preoperative assessment, it is obligatory to monitor arterial blood pressure, heart rate, and arrhythmias and to restore the blood volume to normal.
  
  
  CONCLUSIONS
  In conclusion, due to the pathophysiological complexity of a pheochromocytoma, the strict cooperation between the cardiologist, endocrinologist, surgeon and the anaesthesiologist for an uneventful outcome should be achieved in patients qualified for the surgical removal of such a tumor.
authors.affiliation: Department of Urology, Rydygier Memorial Hospital, Cracow, Poland ; Department of Pathophysiology, Jagiellonian University, Medical College, Cracow, Poland.
authors.forename: Kajetan
authors.initials: K
authors.lastname: Juszczak
authors.affiliation: Department of Regenerative Medicine, Medical College, Nicolaus Copernicus University, Toruń, Poland ; Department of Urology, Nicolaus Copernicus University, Toruń, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Drewa
keywords: adrenergic crisis; pheochromocytoma; surgery