Nursing care during management of recurrent pheochromocytoma: A case study.

Autor: Chen M; The Affiliated Hospital of Putian University, Putian, China., Zhuang Y; The Affiliated Hospital of Putian University, Putian, China., Weng Z; The Affiliated Hospital of Putian University, Putian, China., Zhuang J; The Affiliated Hospital of Putian University, Putian, China., Chen L; School of Nursing, Putian University, Putian, China.
Jazyk: angličtina
Zdroj: Nursing in critical care [Nurs Crit Care] 2024 Oct 11. Date of Electronic Publication: 2024 Oct 11.
DOI: 10.1111/nicc.13165
Abstrakt: Background: Pheochromocytoma can occur in patients with multiple endocrine neoplasia type 2, placing them at increased risk of tumour recurrence after surgical resection. Therefore, management of pheochromocytoma in these patients is a clinical challenge.
Aims: We aim to present and discuss the nursing management of patient with recurrent pheochromocytoma.
Study Design: Case studies. We reviewed and retrieved the necessary information from the medical records.
Results: A 34-year-old female with a history of medullary thyroid carcinoma and pheochromocytoma complicated by cardiomyopathy, who had undergone surgical resections 6 years ago, presented with abdominal pain for 1 day and was diagnosed with recurrent bilateral pheochromocytoma, hypertensive crisis, acute heart failure, and acute renal failure. Eight hours after hospital admission, she experienced sudden cardiac arrest and received cardiopulmonary resuscitations. She was then supported under extracorporeal membrane oxygenation and continuous renal replacement therapy (CRRT). The adrenal tumour was successfully treated with absolute ethanol ablation followed by gelatin sponge particle embolization, a management approach which has not been reported previously. She had a satisfactory recovery.
Conclusions: A comprehensive nursing management approach, including prone ventilation; safe transportation; close cardiopulmonary monitoring; pre-, intra- and post-procedure care; individualized early rehabilitation; and psychological supports, should be applied to improve the prognoses in patients with similar medical conditions.
Relevance to Clinical Practice: Bilateral adrenal pheochromocytoma can be managed by absolute ethanol ablation followed by gelatin sponge particle embolization. Comprehensive nursing management, including a team effort regarding patient positioning, transportation, close monitoring, early rehabilitation and psychological support, should be provided during the peri-procedure period.
(© 2024 British Association of Critical Care Nurses. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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