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 language | English (US) |
|---|---|
| Journal | American Journal of Surgery |
| DOIs | |
| State | Accepted/In press - Jan 1 2019 |
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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 journal › Article
}
TY - JOUR
T1 - Β-Adrenergic agonist administration is not associated with secondary carcinoid crisis in patients with carcinoid tumor
AU - Limbach, Kristen E.
AU - Condron, Mary E.
AU - Bingham, Ann E.
AU - Pommier, Su Ellen Johnson
AU - Pommier, Rodney
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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.
AB - 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.
KW - Carcinoid
KW - Carcinoid crisis
KW - Epinephrine
KW - Vasopressor
KW - β-Adrenergic agonist
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U2 - 10.1016/j.amjsurg.2018.12.070
DO - 10.1016/j.amjsurg.2018.12.070
M3 - Article
C2 - 30635207
AN - SCOPUS:85059568962
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
ER -