Management of hemodynamics during surgical resection of pheochromocytoma using direct charcoal hemoperfusion.

概要

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To stabilize hemodynamics during operations to resect pheochromocytomas, we performed direct hemoperfusion (DHP) using an activated charcoal column in three patients with pheochromocytoma during surgical resection. A Fr. 6-8 catheter was inserted into the femoral vein and its tip was placed in the renal vein at the opening of the adrenal vein. This catheter served as a blood source for DHP and blood was returned to the cephalic vein in the forearm. Although we were unable to control fluctuations in the blood pressure level and heart rate during the operation in case 1, apparently because of the dislocation of a catheter tip, no great fluctuations were observed in cases 2 and 3 in which DHP was highly effective. In an adsorption experiment using human plasma, we were able to adsorb almost 100% of the adrenalin (Ad) and noradrenalin (NA), using an activated charcoal column. Blood concentrations of Ad and NA dropped to an averages of 62.5% and 81.9%, respectively, at the outlet of the column compared to the inlet in vivo.These findings show that DHP effectively removes catecholamines from the blood, and it is useful in stabilizing hemodynamics during operation for resection of pheochromocytoma.
社団法人日本透析医学会の論文