Key result
Perioperative management using alpha- and beta-adrenergic receptor blockers, along with careful fluid and vasoactive drug administration, successfully maintained hemodynamic stability during paraganglioma resection in a child.
Case Report (n=1)
Perioperative management of catecholamine-induced cardiomyopathy in children with paraganglioma should follow adult principles, utilizing alpha- and beta-blockers and diuretics.
May support alpha/beta-blockade for hemodynamic stability in pediatric paraganglioma; leaves open confirmation beyond this single case.
BACKGROUND: Paragangliomas are catecholamine-secreting tumors of the paraganglia. Perioperative mortality of children with paraganglioma is high, but preoperative therapy and anesthetic management of paraganglioma resection are controversial in children. The literatures on catecholamine-induced cardiomyopathy are limited to several case reports,with few reports of studies on children. CASE PRESENTATION: Here we report the anesthetic management of a child with paraganglioma and catecholamine-induced cardiomyopathy, and the possible perioperative anesthesia problems of the paraganglioma resection are discussed. CONCLUSION: Preoperative and intraoperative anesthetic management of Pheochromocytomas children should follow the same principles as for adults, The most important aspects are the control of blood pressure liability and maintenance of adequate blood volume. Pheochromocytomas patient may have cardiomoyopathy due to myocardial toxicity of excessive circulating catecholamines level. The perioperative management of catecholamine-induced cardiomyopathy should include lowering sympathetic activation by means of α-and β-adrenergic receptor blocker and diuretics administration in case of volume overload.
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Jia et al. (2017) conducted a case report in Paraganglioma and catecholamine-induced cardiomyopathy (n=1). Perioperative anesthetic management (including alpha-blockers, vasodilators, and vasopressors) was evaluated on Hemodynamic stability and successful tumor resection. Perioperative management using alpha- and beta-adrenergic receptor blockers, along with careful fluid and vasoactive drug administration, successfully maintained hemodynamic stability during paraganglioma resection in a child.
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