{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T15:29:00Z","timestamp":1746199740224,"version":"3.37.3"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2017,3,24]],"date-time":"2017-03-24T00:00:00Z","timestamp":1490313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2017,3,24]],"date-time":"2017-03-24T00:00:00Z","timestamp":1490313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Severe hyperlactatemia (SH)\/lactic acidosis (LA) after laparoscopic resection of pheochromocytoma is an infrequently reported complication. The study aims to investigate the incidence of this complication and to determine the clinical risk factors. Patients who underwent laparoscopic resection for pheochromocytoma between 2011 and 2014 at Peking Union Medical College Hospital were enrolled. LA was defined as pH\u2009&lt;\u20097.35, bicarbonate &lt;20\u2009mmol\/L, and serum lactate \u22655\u2009mmol\/L; SH as lactate \u22655\u2009mmol\/L; and moderate hyperlactatemia (MH) as lactate 2.5\u20135.0\u2009mmol\/L without evidence of acidosis (pH\u2009&gt;\u20097.35 and\/or bicarbonate &gt;20\u2009mmol\/L). Data concerning patient demographics, clinical history, and laboratory results were collected and statistical analyses were performed. Out of 145 patients, 59 (40.7%) developed post-operative hyperlactatemia. The incidences of MH and SH\/LA were 25.5% and 15.2%, respectively. Multivariate analysis demonstrated that body mass index (BMI) (odds ratio [OR], 1.204; 95% confidence interval [CI], 1.016\u20131.426), 24-hour urine epinephrine concentration (OR, 1.012; 95% CI, 1.002\u20131.022), and tumor size (OR, 1.571; 95% CI, 1.102\u20132.240) were independent predictors of post-operative SH\/LA. The data show that post-operative SH\/LA is not a rare complication after pheochromocytoma resection and may be closely associated with higher BMI, larger tumor size, and higher levels of urine epinephrine.<\/jats:p>","DOI":"10.1038\/s41598-017-00467-3","type":"journal-article","created":{"date-parts":[[2017,3,20]],"date-time":"2017-03-20T15:57:52Z","timestamp":1490025472000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Risk factors of post-operative severe hyperlactatemia and lactic acidosis following laparoscopic resection for pheochromocytoma"],"prefix":"10.1038","volume":"7","author":[{"given":"Shubin","family":"Wu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiyun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Le","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afang","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0528-6971","authenticated-orcid":false,"given":"Yuguang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2017,3,24]]},"reference":[{"key":"467_CR1","doi-asserted-by":"publisher","first-page":"4069","DOI":"10.1210\/jc.2007-1720","volume":"92","author":"K Pacak","year":"2007","unstructured":"Pacak, K. Preoperative management of the pheochromocytoma patient. J Clin Endocrinol Metab \n                           92, 4069\u20134079 (2007).","journal-title":"J Clin Endocrinol Metab"},{"key":"467_CR2","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1046\/j.1365-2265.2001.01360.x","volume":"55","author":"RW McCallum","year":"2001","unstructured":"McCallum, R. W. & Connell, J. M. Laparoscopic adrenalectomy. Clin Endocrinol (Oxf) \n                           55, 435\u2013436 (2001).","journal-title":"Clin Endocrinol (Oxf)"},{"key":"467_CR3","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1097\/SHK.0b013e318167378f","volume":"30","author":"B Levy","year":"2008","unstructured":"Levy, B., Desebbe, O., Montemont, C. & Gibot, S. Increased aerobic glycolysis through beta2 stimulation is a common mechanism involved in lactate formation during shock states. Shock \n                           30, 417\u2013421 (2008).","journal-title":"Shock"},{"key":"467_CR4","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1038\/nrneph.2012.186","volume":"8","author":"JA Kraut","year":"2012","unstructured":"Kraut, J. A. & Madias, N. E. Treatment of acute metabolic acidosis: a pathophysiologic approach. Nat Rev Nephrol \n                           8, 589\u2013601 (2012).","journal-title":"Nat Rev Nephrol"},{"key":"467_CR5","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1016\/j.jclinane.2014.06.005","volume":"26","author":"K Suzuki","year":"2014","unstructured":"Suzuki, K., Tanaka, S., Uchida, T., Nakazawa, K. & Makita, K. Catecholamine release induces elevation in plasma lactate levels in patients undergoing adrenalectomy for pheochromocytoma. J Clin Anesth \n                           26, 616\u2013622 (2014).","journal-title":"J Clin Anesth"},{"key":"467_CR6","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/S0272-6386(87)80182-8","volume":"10","author":"NE Madias","year":"1987","unstructured":"Madias, N. E., Goorno, W. E. & Herson, S. Severe lactic acidosis as a presenting feature of pheochromocytoma. Am J Kidney Dis \n                           10, 250\u2013253 (1987).","journal-title":"Am J Kidney Dis"},{"key":"467_CR7","first-page":"197","volume":"61","author":"M Fujii","year":"2012","unstructured":"Fujii, M., Kawabata, Y., Hayashi, T., Nishimae, H. & Masuko, S. Hyperlactemia during undiagnosed pheochromocytoma resection under laparoscopy. Masui \n                           61, 197\u2013199 (2012).","journal-title":"Masui"},{"key":"467_CR8","doi-asserted-by":"publisher","first-page":"2309","DOI":"10.1056\/NEJMra1309483","volume":"371","author":"JA Kraut","year":"2014","unstructured":"Kraut, J. A. & Madias, N. E. Lactic acidosis. New Engl J Med \n                           371, 2309\u20132319 (2014).","journal-title":"New Engl J Med"},{"key":"467_CR9","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1055\/s-2007-995903","volume":"31","author":"H Ensinger","year":"1996","unstructured":"Ensinger, H. & Georgieff, M. Is sepsis and septic shock due to a global oxygen insufficiency? A review in 2 parts. 2: Sepsis and lactate. Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie \n                           31, 205\u2013215 (1996).","journal-title":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie"},{"key":"467_CR10","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1139\/y92-024","volume":"70","author":"N Yamaguchi","year":"1992","unstructured":"Yamaguchi, N. Sympathoadrenal system in neuroendocrine control of glucose: mechanisms involved in the liver, pancreas, and adrenal gland under hemorrhagic and hypoglycemic stress. Can J Physiol Pharmacol \n                           70, 167\u2013206 (1992).","journal-title":"Can J Physiol Pharmacol"},{"key":"467_CR11","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1172\/JCI109718","volume":"65","author":"DC Deibert","year":"1980","unstructured":"Deibert, D. C. & DeFronzo, R. A. Epinephrine-induced insulin resistance in man. J Clin Invest \n                           65, 717\u2013721 (1980).","journal-title":"J Clin Invest"},{"key":"467_CR12","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.2337\/diacare.23.10.1591","volume":"23","author":"M Bluher","year":"2000","unstructured":"Bluher, M., Windgassen, M. & Paschke, R. Improvement of insulin sensitivity after adrenalectomy in patients with pheochromocytoma. Diabetes Care \n                           23, 1591\u20131592 (2000).","journal-title":"Diabetes Care"},{"key":"467_CR13","doi-asserted-by":"publisher","first-page":"3632","DOI":"10.1210\/jc.2003-030000","volume":"88","author":"TD Wiesner","year":"2003","unstructured":"Wiesner, T. D., Bluher, M., Windgassen, M. & Paschke, R. Improvement of insulin sensitivity after adrenalectomy in patients with pheochromocytoma. J Clin Endocrinol Metab \n                           88, 3632\u20133636 (2003).","journal-title":"J Clin Endocrinol Metab"},{"key":"467_CR14","first-page":"E157","volume":"247","author":"RS Sherwin","year":"1984","unstructured":"Sherwin, R. S. & Sacca, L. Effect of epinephrine on glucose metabolism in humans: contribution of the liver. Am J Physiol \n                           247, E157\u2013E165 (1984).","journal-title":"Am J Physiol"},{"key":"467_CR15","doi-asserted-by":"publisher","first-page":"1020","DOI":"10.1016\/0026-0495(85)90073-3","volume":"34","author":"KE Steiner","year":"1985","unstructured":"Steiner, K. E., Stevenson, R. W., Green, D. R. & Cherrington, A. D. Mechanism of epinephrine\u2019s glycogenolytic effect in isolated canine hepatocytes. Metabolism \n                           34, 1020\u20131023 (1985).","journal-title":"Metabolism"},{"key":"467_CR16","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1152\/ajplegacy.1946.146.5.677","volume":"146","author":"FR Griffith Jr.","year":"1946","unstructured":"Griffith, F. R. Jr., Lockwood, J. E. & Loomis, T. A. The effect of intra-arterially injected adrenalin on blood flow, sugar retention and lactate output of the leg tissues of anesthetized cats. Am J Physiol \n                           146, 677\u2013688 (1946).","journal-title":"Am J Physiol"},{"key":"467_CR17","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1152\/ajplegacy.1947.149.1.64","volume":"149","author":"FR Griffith Jr.","year":"1947","unstructured":"Griffith, F. R. Jr. et al. The effect of intravenous adrenalin on blood flow, sugar retention, lactate output and respiratory metabolism of peripheral (leg) tissues in the anesthetized cat. Am J Physiol \n                           149, 64\u201376 (1947).","journal-title":"Am J Physiol"},{"key":"467_CR18","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1097\/CCM.0b013e3181ffe0eb","volume":"39","author":"B Levy","year":"2011","unstructured":"Levy, B., Perez, P., Perny, J., Thivilier, C. & Gerard, A. Comparison of norepinephrine-dobutamine to epinephrine for hemodynamics, lactate metabolism, and organ function variables in cardiogenic shock. A prospective, randomized pilot study. Crit Care Med \n                           39, 450\u2013455 (2011).","journal-title":"Crit Care Med"},{"key":"467_CR19","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1016\/j.surg.2015.09.016","volume":"159","author":"T Namekawa","year":"2016","unstructured":"Namekawa, T. et al. Clinical predictors of prolonged postresection hypotension after laparoscopic adrenalectomy for pheochromocytoma. Surgery \n                           159, 763\u2013770 (2016).","journal-title":"Surgery"},{"key":"467_CR20","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1210\/jc.2009-1051","volume":"95","author":"H Bruynzeel","year":"2010","unstructured":"Bruynzeel, H. et al. Risk Factors for hemodynamic instability during surgery for pheochromocytoma. J Clin Endocrinol Metab \n                           95, 678\u2013685 (2010).","journal-title":"J Clin Endocrinol Metab"},{"key":"467_CR21","doi-asserted-by":"publisher","first-page":"1415","DOI":"10.1016\/S0140-6736(05)66378-7","volume":"365","author":"RH Eckel","year":"2005","unstructured":"Eckel, R. H., Grundy, S. M. & Zimmet, P. Z. The metabolic syndrome. Lancet \n                           365, 1415\u20131428 (2005).","journal-title":"Lancet"},{"key":"467_CR22","doi-asserted-by":"publisher","first-page":"2438","DOI":"10.1172\/JCI117252","volume":"93","author":"G Boden","year":"1994","unstructured":"Boden, G., Chen, X., Ruiz, J., White, J. V. & Rossetti, L. Mechanisms of fatty acid-induced inhibition of glucose uptake. J Clin Invest \n                           93, 2438\u20132446 (1994).","journal-title":"J Clin Invest"},{"key":"467_CR23","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1111\/j.1440-1681.1998.tb02181.x","volume":"25","author":"R Donnelly","year":"1998","unstructured":"Donnelly, R. & Qu, X. Mechanisms of insulin resistance and new pharmacological approaches to metabolism and diabetic complications. Clin Exp Pharmacol Physiol \n                           25, 79\u201387 (1998).","journal-title":"Clin Exp Pharmacol Physiol"},{"key":"467_CR24","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1111\/j.1440-1681.1992.tb00425.x","volume":"19","author":"Y Hasin","year":"1992","unstructured":"Hasin, Y., Kneen, M. M., Craik, D. J. & Nayler, W. G. Relationship between ATP resynthesis and calcium accumulation in the reperfused rat heart. Clin Exp Pharmacol Physiol \n                           19, 79\u201387 (1992).","journal-title":"Clin Exp Pharmacol Physiol"},{"key":"467_CR25","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1177\/1553350610365703","volume":"17","author":"Y Erbil","year":"2010","unstructured":"Erbil, Y. et al. The effect of retroperitoneal fat mass on surgical outcomes in patients performing laparoscopic adrenalectomy: the effect of fat tissue in adrenalectomy. Surg Innov \n                           17, 114\u2013119 (2010).","journal-title":"Surg Innov"},{"key":"467_CR26","doi-asserted-by":"publisher","first-page":"2082","DOI":"10.1016\/S0003-4975(00)02160-3","volume":"70","author":"P Demers","year":"2000","unstructured":"Demers, P., Elkouri, S., Martineau, R., Couturier, A. & Cartier, R. Outcome with high blood lactate levels during cardiopulmonary bypass in adult cardiac operation. Ann Thorac Surg \n                           70, 2082\u20132086 (2000).","journal-title":"Ann Thorac Surg"},{"key":"467_CR27","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1097\/CCM.0000000000000742","volume":"43","author":"B Casserly","year":"2015","unstructured":"Casserly, B. et al. Lactate measurements in sepsis-induced tissue hypoperfusion: results from the Surviving Sepsis Campaign database. Crit Care Med \n                           43, 567\u2013573 (2015).","journal-title":"Crit Care Med"},{"key":"467_CR28","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1016\/j.annemergmed.2004.12.006","volume":"45","author":"NI Shapiro","year":"2005","unstructured":"Shapiro, N. I. et al. Serum lactate as a predictor of mortality in emergency department patients with infection. Ann Emerg Med \n                           45, 524\u2013528 (2005).","journal-title":"Ann Emerg Med"},{"key":"467_CR29","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1016\/j.annemergmed.2012.10.022","volume":"61","author":"S Vanni","year":"2013","unstructured":"Vanni, S. et al. Prognostic value of plasma lactate levels among patients with acute pulmonary embolism: the thrombo-embolism lactate outcome study. Ann Emerg Med \n                           61, 330\u2013338 (2013).","journal-title":"Ann Emerg Med"},{"key":"467_CR30","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/2110-5820-3-6","volume":"3","author":"PA van Beest","year":"2013","unstructured":"van Beest, P. A. et al. Cumulative lactate and hospital mortality in ICU patients. Ann Intensive Care \n                           3, 6 (2013).","journal-title":"Ann Intensive Care"},{"key":"467_CR31","first-page":"593","volume":"38","author":"J Zaludik","year":"2010","unstructured":"Zaludik, J., Schuitemaker, F., DeWaal, R., Veldjuijzen, B. & Van der Meer, N. Severe lactate acidosis and cardiogenic shock: a rare manifestation of a phaeochromocytoma. Anaesth Intensive Care \n                           38, 593\u2013594 (2010).","journal-title":"Anaesth Intensive Care"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-00467-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-00467-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-00467-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T03:18:29Z","timestamp":1671765509000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-00467-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,24]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,12]]}},"alternative-id":["467"],"URL":"https:\/\/doi.org\/10.1038\/s41598-017-00467-3","relation":{},"ISSN":["2045-2322"],"issn-type":[{"type":"electronic","value":"2045-2322"}],"subject":[],"published":{"date-parts":[[2017,3,24]]},"assertion":[{"value":"15 July 2016","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 February 2017","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 March 2017","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"403"}}