Severe intra‐operative carcinoid crisis in a patient having carcinoid heart disease

Yazbek-Karam, V. G.; Haswani, R. W.; Mousallem, N. M.; Jaoude, Elizabeth Abou; Nassar, N. E.; Hirbli, K. E.; El-Khoury, J; Tarcha, W; Baraka, Anis; Aouad, Marie T.

doi:10.1111/j.1399-6576.2008.01870.x

Cited by 7 publications

(7 citation statements)

References 5 publications

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“…(Ahlman et al, 1987;Marsh et al, 1987;Roy et al, 1987;Ahlman et al, 1988a;Ockert and White, 1988;Darby et al, 1990;Debas and Mulvihill, 1994;Deguchi et al, 1994;Parry et al, 1996;Pekarek et al, 1997;Balestrero et al, 2000;Janssen et al, 2000;Kharrat and Taubin, 2003;Zimmer et al, 2003;Koopmans et al, 2005;Davi et al, 2006;Majeed et al, 2007;Papadogias et al, 2007;De Keizer et al, 2008;McPherson et al, 2009;Sinha et al, 2009;Yazbek-Karam et al, 2009;Fujie et al, 2010;Morrisroe et al, 2012;Raikhelkar et al, 2012;Shah et al, 2012;Massimino et al, 2013;van Diepen et al, 2013) The prophylactic usage of SSTA was diverse between different studies varying from long acting SSTA to continuous somatostatin infusion. Of the 28 patients with known demographic information, 17 cases (60.7%) were men and 11 cases (39.3%) were women.…”

Section: Resultsmentioning

confidence: 99%

Somatostatin Analogues Do Not Prevent Carcinoid Crisis

Guo

Tang²

2014

Asian Pacific Journal of Cancer Prevention

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Background: Carcinoid crisis is a life-threating syndrome of neuroendocrine tumors (NETs) characterized by dramatic blood pressure fluctuation, arrhythmias, and bronchospasm. In the era of booming anti-tumor therapeutics, this has become more important since associated stresses can trigger carcinoid crisis. Somatostatin analogues (SSTA) have been recommended for prophylactic administration before intervention procedures for functioning NETs. However, the efficacy is still controversial. The aim of this article is to review efficacy of SSTA for preventing carcinoid crisis. Materials and Methods: PubMed, Cochrane Controlled trials Register, and EMBASE were searched using 'carcinoid crisis' as a search term combining terms with 'somatostatin'; 'octreotide'; 'lanreotide' and 'pasireotide' until December 2013. Results: Twenty-eight articles were retrieved with a total of fifty-three unique patients identified for carcinoid crisis. The most common primary sites of NETs were the small intestine and respiratory tract. The triggering factors for carcinoid crisis included anesthesia/ surgery (63.5%), interventional therapy (11.5%), radionuclide therapy (9.6%), examination (7.7%), medication (3.8%), biopsy (2%) and spontaneous (2%). No randomized controlled trials (RCTs) were identified and two case-control studies were included to assess the efficacy of SSTA for preventing carcinoid crisis by meta-analysis. The overall pooled risk of perioperative carcinoid crisis was similar despite the prophylactic administration of SSTA (OR 0.44, 95% CI: 0.14 to 1.35, p=0.15). Conclusions: SSTA wasnot helpful for preventing carcinoid crisis based on a meta-analysis of retrospective studies. Attentive monitoring and careful intervention are essential. Future studies with better quality are needed to clarify any effect of SSTA for preventing carcinoid crisis.

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Section: Resultsmentioning

confidence: 99%

Somatostatin Analogues Do Not Prevent Carcinoid Crisis

Guo

Tang²

2014

Asian Pacific Journal of Cancer Prevention

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“…Peri-operative management: the surgical approach for CHD patients requires a highly skilled multidisciplinary team with broad experience, as anaesthesia can trigger carcinoid crisis and subsequent death in patients going for surgery. 26,[40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] The most crucial pre-operative anaesthetic management should encompass optimum control of carcinoid symptoms, and intensified and close monitoring of intra-operative blockade of serotonin receptors. Drugs that may stimulate the release of vasoactive substances from tumour cells should be avoided.…”

Section: Management Strategies For Chdmentioning

confidence: 99%

“…Drugs that may stimulate the release of vasoactive substances from tumour cells should be avoided. 26,[40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] The most important drugs to be avoided during the peri-operative period include histamine-releasing neuromuscular relaxants and opioids, as they are associated with detrimental outcomes in CHD patients. The introduction of somatostatin analogues remains a key component to prevent peri-operative carcinoid crisis, and the administration of larger doses of somatostatin analogue is highly recommended in CHD patients.…”

Section: Management Strategies For Chdmentioning

confidence: 99%

Cases in a series of carcinoid syndrome and carcinoid heart disease

Matshela

2018

CVJA

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Although carcinoid syndrome is regarded as a rare entity, carcinoid patients with evidence of cardiac involvement show a markedly reduced survival time. Patients with advanced signs of right-sided heart failure represent a subgroup at particularly high risk. Echocardiography remains the gold standard to diagnose or confirm structural cardiac involvement in patients with underlying carcinoid disease. This is the notion that propelled us to report on cases of carcinoid syndrome with cardiac involvement. We also review carcinoid syndrome and carcinoid heart disease, and challenges regarding the diagnosis and management of carcinoid heart disease.

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“…Seventeen of the included articles are case reports involving 18 patients experiencing a carcinoid crisis. 9,13,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] One publication is a retrospective chart review describing 89 patients experiencing a carcinoid crisis. 33 Some patients experienced more than one crisis.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…33 Some patients experienced more than one crisis. 25,32 Study characteristics, octreotide dose characteristics, and crisis symptoms of all case reports are shown in Table 1. All studies were published between 1985 and 2010.…”

Section: Study Characteristicsmentioning

confidence: 99%

Mega-dose intravenous octreotide for the treatment of carcinoid crisis: a systematic review

Seymour

Sawh

2013

Can J Anesth/J Can Anesth

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In the included case reports, carcinoid crises were managed effectively using octreotide 25-500 μg iv. Previous exposure to octreotide and carcinoid heart disease may warrant the need for higher doses. In addition to the low quality of the articles and the small sample size, inconsistent use of the term "carcinoid crisis" and paucity of reported outcomes were also limitations of this systematic review. These findings highlight the need for further investigation into dose-response relationships of octreotide for the treatment of carcinoid crisis.

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Severe intra‐operative carcinoid crisis in a patient having carcinoid heart disease

Cited by 7 publications

References 5 publications

Somatostatin Analogues Do Not Prevent Carcinoid Crisis

Somatostatin Analogues Do Not Prevent Carcinoid Crisis

Cases in a series of carcinoid syndrome and carcinoid heart disease

Mega-dose intravenous octreotide for the treatment of carcinoid crisis: a systematic review

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