Trial Information

Non-invasive Evaluation of Fluid Status and Cardiac Output During Operative Treatment of Pheochromcytoma

Pheochromocytomas and extraadrenal paragangliomas are catecholamin-producing tumours
deriving from the adrenal medulla and sympathetic ganglia. The only causal therapy is
surgical resection. Nowadays, laparoscopic adrenalectomy is thought to be the optimal
approach. Chronic volume depletion due to chronic hypertension and preoperative
α-adrenoreceptor-blockade (to avoid the effects of intraoperative catecholamine-excess)
often lead to hypotension after resection of the tumour. Volume reload with high amounts of
fluid is often needed. Therefor some authors recommended invasive measurement (pulmonary
artery catheter) to control cardiac output parameters and fluid balance. However, there are
non-invasive methods to measure cardiac output(CO), systemic vascular resistance(SVR),
stroke volume(SV) and corrected aortic flow time(FTc) to estimate volume status. Except
transesophageal echocardiography, other techniques such as transoesophageal doppler and
pulse pressure methods exist but have not been investigated during surgical therapy for
pheochromocytoma so far. The esophageal Doppler currently represents the "gold standard" for
perioperative fluid replacement therapy.

The study's hypothesis is that non-invasive measurements of cardiac output (CO), systemic
vascular resistance (SVR), corrected aortic flow time (FTc) and stroke volume (SV) are
useful parameters during laparoscopic resection of pheochromocytoma (adrenalectomy) to
document the intraoperative changes in volume status and to estimate the volume depletion.