Β-Adrenergic agonist administration is not associated with secondary carcinoid crisis in patients with carcinoid tumor

Limbach, Kristen E.; Condron, Mary; Bingham, A.; Pommier, Su Ellen J.; Pommier, Rodney F.

doi:10.1016/j.amjsurg.2018.12.070

Cited by 16 publications

(11 citation statements)

References 14 publications

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“…Kinins cause profound vasomotor relaxation resulting in severe hypotension and flushing [7]. However, a recent study revealed that β-adrenergic agonist use was not associated with paradoxical hypotension, prolonged carcinoid crisis, or postoperative complications in patients with intraoperative carcinoid crisis [8]. There is an ongoing controversy about the role of preoperative parenteral octreotide in carcinoid crisis prevention with only weak supporting evidence for its use [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

A Challenging Case of Carcinoid Crisis in a Patient With Neuroendocrine Tumor

Mahdi¹,

Özer²,

Tahseen

2021

Cureus

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Section: Discussionmentioning

confidence: 99%

A Challenging Case of Carcinoid Crisis in a Patient With Neuroendocrine Tumor

Mahdi¹,

Özer²,

Tahseen

2021

Cureus

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“…Notably, Limbach et al retrospectively examined the use of vasoactive medications during CC to determine whether an association between induction of a secondary CC and beta-adrenergic agonist administration could be detected. They observed no close correlation between the use of sympathomimetic drugs and secondary CC and, in addition, the duration of CC did not increase with administration of beta-adrenergic agonists [48].…”

Section: Vasopressorsmentioning

confidence: 91%

“…The Authors noted decreased systemic blood pressure, decreased vascular resistance and an elevated bradykinin level for 5 min after injection, although the response was quite variable among the 7 patients [47]. However, data supporting a widespread concern about the abuse of beta-adrenergic agonists remain very limited [48].…”

Section: Vasopressorsmentioning

confidence: 99%

“…More recent experiences have tried to explore the real role of this class of drugs in the management of intraoperative CC [10,26,48]. Notably, Limbach et al retrospectively examined the use of vasoactive medications during CC to determine whether an association between induction of a secondary CC and beta-adrenergic agonist administration could be detected.…”

Section: Vasopressorsmentioning

confidence: 99%

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Carcinoid Crisis: A Misunderstood and Unrecognized Oncological Emergency

Bardasi

Benatti

Luppi

et al. 2022

Cancers

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Carcinoid Crisis represents a rare and extremely dangerous manifestation that can occur in patients with Neuroendocrine Tumors (NETs). It is characterized by a sudden onset of hemodynamic instability, sometimes associated with the classical symptoms of carcinoid syndrome, such as bronchospasm and flushing. Carcinoid Crisis seems to be caused by a massive release of vasoactive substances, typically produced by neuroendocrine cells, and can emerge after abdominal procedures, but also spontaneously in rare instances. To date, there are no empirically derived guidelines for the management of this cancer-related medical emergency, and the available evidence essentially comes from single-case reports or dated small retrospective series. A transfer to the Intensive Care Unit may be necessary during the acute setting, when the severe hypotension becomes unresponsive to standard practices, such as volemic filling and the infusion of vasopressor therapy. The only effective strategy is represented by prevention. The administration of octreotide, anxiolytic and antihistaminic agents represents the current treatment approach to avoid hormone release and prevent major complications. However, no standard protocols are available, resulting in great variability in terms of schedules, doses, ways of administration and timing of prophylactic treatments.

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“…Por otro lado, la crisis carcinoide es una de las complicaciones más preocupantes en el paciente con síndrome carcinoide, pues debido a la rápida liberación de las sustancias vasoactivas como la bradicinina, y en segunda estancia, serotonina e histamina, presenta una marcada inestabilidad hemodinámica debido a una profunda relajación vasomotora, la cual puede estar acompañada de enrojecimiento y broncoespasmo, con manifestaciones tan agresivas que incluyen arritmias, hipotensión profunda, falla multiorgánica y hasta la muerte [7,9,10]. En este tipo de choque, los análisis hemodinámicos con catéter de arteria pulmonar, no evidencian una causa cardiopulmonar del choque, expresán-dose más bien como un choque distributivo con disminución tanto de las presiones de llenado intracardiaco como de la presión arterial pulmonar media y de la resistencia vascular sistémica, con un adecuado gasto cardiaco [7,11].…”

Section: Caso Clínicounclassified

Crisis carcinoide como una causa poco frecuente de choque distributivo

Benítez-Patiño

Tibavizco-Palacios

2022

Med. Lab.

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Los tumores neuroendocrinos son neoplasias que suelen tener un comportamiento clínico maligno, son provenientes de células entero cromafines y/o células productoras de gastrina. Según su origen anatómico, se clasifican en tumores del intestino anterior (comprometen estómago, duodeno, pulmones y páncreas), intestino medio (parte distal del duodeno) e intestino posterior (colon transverso hasta el recto). El síndrome carcinoide, presente en la mitad de los casos al momento del diagnóstico, se caracteriza por desencadenar episodios de diarrea, taquicardia, hipotensión, rubor (por el desarrollo de telangiectasias), y según la gravedad, valvulopatías cardiacas. Por otro lado, la crisis carcinoide, una complicación infrecuente, está relacionada con episodios de choque, que cuando ocurren son consecuencia de la liberación en la circulación sistémica de aminas vasoactivas, posterior a un evento desencadenante. A continuación, se presenta el caso de un paciente masculino con antecedente de un tumor neuroendocrino de intestino delgado, quien luego de ser llevado a embolización de metástasis hepáticas, presentó una crisis carcinoide, y finalmente un choque distributivo refractario a tratamientos convencionales, incluyendo octreotide y vasopresores, que culminó con la muerte del paciente. Se realiza la discusión del caso clínico y la presentación de la literatura disponible, donde se describe la epidemiología, patogénesis, diagnóstico, clínica y tratamiento de esta entidad.

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Β-Adrenergic agonist administration is not associated with secondary carcinoid crisis in patients with carcinoid tumor

Cited by 16 publications

References 14 publications

A Challenging Case of Carcinoid Crisis in a Patient With Neuroendocrine Tumor

A Challenging Case of Carcinoid Crisis in a Patient With Neuroendocrine Tumor

Carcinoid Crisis: A Misunderstood and Unrecognized Oncological Emergency

Crisis carcinoide como una causa poco frecuente de choque distributivo

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