Intraoperative hemodynamics monitoring in a patient with pheochromocytoma multisystem crisis: a case report

BACKGROUND: Pheochromocytoma is a rare catecholamine-secreting tumor. To evaluate the intraoperative hemodynamics with precision is difficult. CASE PRESENTATION: A 42-year-old man, who suddenly developed a life-threatening pheochromocytoma multisystem crisis that occurred during preoperative prophylactic medication, underwent urgent bilateral adrenalectomy. For the purpose of evaluating the intraoperative hemodynamics, we monitored both pulmonary artery catheter-based cardiac output (PACO) and arterial pressure-based cardiac output (APCO; FloTrac™). APCO fluctuated in poor agreement with the change in PACO, especially in the state of cytokine storming. CONCLUSIONS: Overall, the value of stroke volume variation derived from FloTrac™ changed in tandem with the intraoperative volume status, indicating its utility as a marker of circulatory hemodynamics.