Bi-national Review of Phaeochromocytoma Care: Is ICU Admission Always Necessary?
- PDF / 240,693 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 29 Downloads / 175 Views
ORIGINAL SCIENTIFIC REPORT
Bi-national Review of Phaeochromocytoma Care: Is ICU Admission Always Necessary? Alexander J. Papachristos1,5 • Tiffany J. Cherry1 • Munyaradzi G. Nyandoro3 • Dean Lisewski3 • Sarah-Jayne Stevenson4 • Philippa Mercer4 • Suren Subramaniam5 • Stan B. Sidhu5 • Mark S. Sywak5 • Nicholas D. A. Blefari6,7 • Christine J. O’Neill6,7 • Justin S. Gundara8,9,10 • Julie A. Miller1,2,11
Accepted: 7 November 2020 Ó Socie´te´ Internationale de Chirurgie 2020, corrected publication 2020
Abstract Background Post-operative management after phaeochromocytoma resection includes monitoring of blood pressure and blood sugar, and vigilance for haemorrhage. Guidelines recommend 24 h of continuous blood pressure monitoring, usually necessitating HDU/ICU admission. We hypothesised that most patients undergoing phaeochromocytoma resection do not require post-operative HDU/ICU admission. We aim to describe current Australian and New Zealand perioperative management of phaeochromocytoma and determine whether it is safe to omit HDU/ICU care for most patients. Methods We collected retrospective data on patients undergoing excision of phaeochromocytoma in 12 centres around Australia and New Zealand between 2007 and 2019. Data collected included preoperative medical management, anaesthetic management, vasopressor support, HDU/ICU admission and complications. Results A total of 223 patients were included in the study, 173 (77%) of whom were admitted to HDU/ICU postoperatively. The group of patients treated in ICU was similar to the group of patients treated on the ward in terms of demographic and tumour characteristics, and there were significant differences in the proportion of patients admitted to HDU/ICU between centres. Of patients admitted to ICU, 71 (41%) received vasopressor support. This was weaned within 24 h in 55 (77%) patients. Patients with larger tumours ([ 6 cm) and a transfusion requirement are more likely to require prolonged inotropic support. Among patients admitted to the ward, there were no complications that required escalation of care. Conclusions Although not widespread practice in Australia and New Zealand, it appears safe for the majority of patients undergoing minimally invasive resection of phaeochromocytoma to be admitted to the ward post-operatively.
& Alexander J. Papachristos [email protected] 1
Endocrine Surgery Unit, Royal Melbourne Hospital, Grattan St. Parkville, Melbourne, VIC 3050, Australia
2
Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
3
Department of General Surgery, Fiona Stanley Hospital, Melville, WA, Australia
4
Department of Endocrine Surgery, Christchurch Hospital, Canterbury DHB, Christchurch, New Zealand
5
Endocrine Surgery Unit, University of Sydney, Royal North Shore Hospital, Sydney, NSW, Australia
6
Division of Surgery, John Hunter Hospital, Newcastle, NSW, Australia
7
School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
8
Department of General and Endocrine Surgery, Logan Hospital,
Data Loading...
