Β-Adrenergic agonist administration is not associated with secondary carcinoid crisis in patients with carcinoid tumor

Kristen E. Limbach, Mary E. Condron, Ann E. Bingham, Su Ellen Johnson Pommier, Rodney Pommier

    Research output: Contribution to journalArticle

    Abstract

    Background: Patients with carcinoid tumors are at risk for profound intraoperative hypotension known as carcinoid crisis, which catecholamines are traditionally believed to trigger. However, data supporting this are lacking. Methods: Anesthesia records were retrospectively reviewed for carcinoid patients treated with vasopressors. Hemodynamics for those with crisis were compared between those who received β-adrenergic agonists (B-AA) versus those who did not. Results: Among 293 consecutive operations, 58 were marked by 161 crises. There was no significant difference in the incidence of paradoxical hypotension with B-AA compared to non-B-AA (p = 0.242). The maximum percent decrease in mean arterial pressure following drug administration was significantly greater in those patients treated with non-B-AA than with B-AA (31.6% vs. 12.5%, p < 0.0001). There were no differences in crisis duration (p = 0.257) or postoperative complication rate (p = 0.896). Conclusions: β-Adrenergic agonist use was not associated with paradoxical hypotension, prolonged carcinoid crisis, or postoperative complications in patients with intraoperative carcinoid crisis.

    Original languageEnglish (US)
    JournalAmerican Journal of Surgery
    DOIs
    StateAccepted/In press - Jan 1 2019

    Fingerprint

    Adrenergic Agonists
    Carcinoid Tumor
    Hypotension
    Catecholamines
    Arterial Pressure
    Anesthesia
    Hemodynamics
    Incidence
    Pharmaceutical Preparations

    Keywords

    • Carcinoid
    • Carcinoid crisis
    • Epinephrine
    • Vasopressor
    • β-Adrenergic agonist

    ASJC Scopus subject areas

    • Surgery

    Cite this

    Β-Adrenergic agonist administration is not associated with secondary carcinoid crisis in patients with carcinoid tumor. / Limbach, Kristen E.; Condron, Mary E.; Bingham, Ann E.; Pommier, Su Ellen Johnson; Pommier, Rodney.

    In: American Journal of Surgery, 01.01.2019.

    Research output: Contribution to journalArticle

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    abstract = "Background: Patients with carcinoid tumors are at risk for profound intraoperative hypotension known as carcinoid crisis, which catecholamines are traditionally believed to trigger. However, data supporting this are lacking. Methods: Anesthesia records were retrospectively reviewed for carcinoid patients treated with vasopressors. Hemodynamics for those with crisis were compared between those who received β-adrenergic agonists (B-AA) versus those who did not. Results: Among 293 consecutive operations, 58 were marked by 161 crises. There was no significant difference in the incidence of paradoxical hypotension with B-AA compared to non-B-AA (p = 0.242). The maximum percent decrease in mean arterial pressure following drug administration was significantly greater in those patients treated with non-B-AA than with B-AA (31.6{\%} vs. 12.5{\%}, p < 0.0001). There were no differences in crisis duration (p = 0.257) or postoperative complication rate (p = 0.896). Conclusions: β-Adrenergic agonist use was not associated with paradoxical hypotension, prolonged carcinoid crisis, or postoperative complications in patients with intraoperative carcinoid crisis.",
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    AU - Condron, Mary E.

    AU - Bingham, Ann E.

    AU - Pommier, Su Ellen Johnson

    AU - Pommier, Rodney

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