Pheochromocytoma

Management of paroxysms of hypertension in patients with phaeochromocytomas

“…The use of prolonged alpha-blockage is based partly on the finding that prolonged infusion of noradrenaline causes a reduction in circulating plasma volume (Finnerty, Buchholz, and Guillaudeu, 1958) and partly on studies which showed that patients with phaeochromocytomas might have reduced circulating plasma volume and red-cell mass (Brunjes, Johns, and Crane, 1960). Although other workers have failed to confirm these latter findings fully (Sjoerdsma, Waldmann, Cooperman, and Hammond, 1966), the consensus of opinion is that removal of a phaeochromocytoma results in vasodilatation with expansion of the intravascular space and hypovolaemia.…”

Preoperative and operative management of patients with phaeochromocytoma.

“…Patients with a phaeochromocytoma may also have a reduced circulating plasma volume and sometimes also a reduced red-cell volume (Brunjes, Johns, and Crane, 1960). This hypovolaemia is an important factor contributing to the hypotension that follows removal of the tumour in the patient not prepared preoperatively by adequate a-receptor blockade.…”

The adrenal glands and hypertension: Surgical aspects

“…Occasionally the bloodpressure does not respond to metaraminol, but does do so to an infusion of blood-plasma, even when the loss of blood has not been great. Apparently widespread vasodilatation, which is no longer responsive to adrenergic stimuli, demands a rapid increase in the blood-volume (Brunjes, Johns, and Crane, 1960). I n other patients the blood-pressure responds to metaraminol, but there may be difficulty in withdrawing it.…”