{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:26Z","timestamp":1784557046112,"version":"3.55.0"},"reference-count":11,"publisher":"Bioscientifica","issue":"2","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Phaeochromocytoma, a rare neuroendocrine tumour of chromaffin cell origin, is characterised by catecholamine excess. Clinical presentation ranges from asymptomatic disease to life-threatening multiorgan dysfunction. Catecholamine-induced cardiomyopathy is a dreaded complication with high lethality. While there is lack of evidence-based guidelines for use of veno-arterial extracorporeal membrane oxygenation (V-A ECMO) in the management of this condition, limited to case reports and small case series, V-A ECMO has been reported as \u2018bridge to recovery\u2019 therapy, providing circulatory support in the initial period of stabilisation prior to surgery. We report on two patients presenting with catecholamine-induced cardiomyopathy and circulatory collapse who were successfully treated with V-A ECMO for 5 and 6 days, respectively, providing initial haemodynamic support. After stabilisation and introduction of alpha-blockade, both cases had favourable outcomes, with successful laparoscopic adrenalectomies on days 62 and 83 of admission, respectively. Our case reports provide further support for the use of V-A ECMO in the treatment of such gravely ill patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Phaeochromocytoma should be considered in the diagnosis of patients presenting with acute cardiomyopathy.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Management of catecholamine-induced cardiomyopathy is complex and requires multidisciplinary specialist input.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Pre-operative management of phaeochromocytoma involves alpha-blockade; however, haemodynamic instability in the setting of cardiogenic shock can preclude alpha-blockade use.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Veno-arterial extracorporeal membrane oxygenation is a life-saving intervention which may be considered in cases of acute catecholamine-induced cardiomyopathy and cardiogenic shock in order to provide the required haemodynamic support in the initial phase of treatment, enabling the administration of traditional pharmacological agents, including alpha-blockade.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-22-0392","type":"journal-article","created":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T06:37:57Z","timestamp":1681886277000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":0,"title":["Two cases of cardiomyopathy associated with phaeochromocytoma successfully managed with veno-arterial extracorporeal membrane oxygenation (V-A ECMO)"],"prefix":"10.1530","volume":"2023","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6066-8318","authenticated-orcid":true,"given":"David","family":"Fennell","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0193-8976","authenticated-orcid":true,"given":"Clare","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9597-9471","authenticated-orcid":true,"given":"Stephen","family":"Ludgate","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Conneely","sequence":"additional","affiliation":[{"name":"Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Mater Misericordiae University Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Conrick-Martin","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Mater Misericordiae University Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Hastings","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Mater Misericordiae University Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siobh\u00e1n E","family":"McQuaid","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland"},{"name":"School of Medicine, University College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"1386","article-title":"Pheochromocytoma characteristics and behavior differ depending on method of discovery","volume":"104","author":"Gruber","year":"2019","unstructured":"Gruber LMHartman RPThompson GBMcKenzie TJLyden MLDy BMYoung WF & Bancos I. Pheochromocytoma characteristics and behavior differ depending on method of discovery. Journal of Clinical Endocrinology and Metabolism20191041386\u20131393. (https:\/\/doi.org\/10.1210\/jc.2018-01707)"},{"key":"bib2","series-title":"Heart","first-page":"1438","article-title":"Acute catecholamine cardiomyopathy in patients with phaeochromocytoma or functional paraganglioma","volume":"99","author":"Giavarini","year":"2013","unstructured":"Giavarini AChedid ABobrie GPlouin PFHag\u00e8ge A & Amar L. Acute catecholamine cardiomyopathy in patients with phaeochromocytoma or functional paraganglioma. Heart2013991438\u20131444. (https:\/\/doi.org\/10.1136\/heartjnl-2013-304073)"},{"key":"bib3","series-title":"European Journal of Endocrinology","first-page":"757","article-title":"Life-threatening events in patients with phaeochomocytoma","volume":"173","author":"Riester","year":"2015","unstructured":"Riester AWeismann DQuinkler MLichtenauer UDSommerey SHalbritter RPenning RSpitzweg CSchopohl JBeuschlein F, Life-threatening events in patients with phaeochomocytoma. European Journal of Endocrinology2015173757\u2013764. (https:\/\/doi.org\/10.1530\/EJE-15-0483)"},{"key":"bib4","series-title":"Clinical Endocrinology","first-page":"13","article-title":"Phaeochromocytoma crisis","volume":"80","author":"Whitelaw","year":"2014","unstructured":"Whitelaw BCPrague JKMustafa OGSchulte KMHopkins PAGilbert JAMcGregor AM & Aylwin SJB. Phaeochromocytoma crisis. Clinical Endocrinology20148013\u201322. 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(https:\/\/doi.org\/10.1186\/s13613-016-0219-4)"},{"key":"bib7","series-title":"Endocrine-Related Cancer","first-page":"T201","article-title":"65 years OF THE Double HELIX: genetics informs precision practice in the diagnosis and management of pheochromocytoma","volume":"25","author":"Neumann","year":"2018","unstructured":"Neumann HPYoung WFJrKrauss TBayley JPSchiavi FOpocher GBoedeker CCTirosh ACastinetti FRuf J, 65 years OF THE Double HELIX: genetics informs precision practice in the diagnosis and management of pheochromocytoma. Endocrine-Related Cancer201825T201\u2013T219. (https:\/\/doi.org\/10.1530\/ERC-18-0085)"},{"key":"bib11","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"1915","article-title":"Phaeochromocytoma and paraganglioma: an Endocrine Society clinical practice guideline","volume":"99","author":"Lenders","year":"2014","unstructured":"Lenders JWDuh QYEisenhofer GGimenez-Roqueplo APGrebe SKMurad MHNaruse MPacak KYoung WF & Endocrine Society. Phaeochromocytoma and paraganglioma: an Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism2014991915\u20131942. (https:\/\/doi.org\/10.1210\/jc.2014-1498)"},{"key":"bib8","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"3088","article-title":"Approach to the patient: perioperative management of the patient with pheochromocytoma or sympathetic paraganglioma","volume":"105","author":"Berends","year":"2020","unstructured":"Berends AMAKerstens MNLenders JWM & Timmers HJLM. Approach to the patient: perioperative management of the patient with pheochromocytoma or sympathetic paraganglioma. Journal of Clinical Endocrinology and Metabolism20201053088\u20133102. (https:\/\/doi.org\/10.1210\/clinem\/dgaa441)"},{"key":"bib9","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"2381","article-title":"Efficacy of \u03b1-blockers on hemodynamic control during pheochromocytoma resection: A randomized controlled trial","volume":"105","author":"Buitenwerf","year":"2020","unstructured":"Buitenwerf EOsinga TETimmers HJLMLenders JWMFeelders RAEekhoff EMWHaak HRCorssmit EPMBisschop PHLTValk GD, Efficacy of \u03b1-blockers on hemodynamic control during pheochromocytoma resection: A randomized controlled trial. Journal of Clinical Endocrinology and Metabolism20201052381\u20132391. 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