Extracorporeal membrane oxygenation combined with intra-aortic balloon counterpulsation for pheochromocytoma: A case report

Table 1 Laboratory test results at admission

Laboratory tests	Time
	April 11	April 12	April 15	April 18	April 21	April 24	April 25
Blood
WBC (109/L)	33.8	24.9	16.1	11.9	31.8	12.7	20.1
Lymph (%)	17	4.4	12.4	17.4	6.6	7.1	3.6
Neut (%)	79.8	93	81.1	72	89.6	88.6	93.5
Hb (g/L)	163	137	106	73	71	73	81
Plt (109/L)	198	102	58	65	120	203	250
C-reactive protein	< 0.2	78.2	51.8	28.5	37.9	55.9	63.3
PCT (ng/mL)	0.03	3.949	1.268	0.585	0.578	-	-
K (mmol/L)	2.75	3.24	3.9	4.62	3.71	4.17	3.95
Na (mmol/L)	135.7	145.5	146.7	144.5	144.3	144.6	135.6
Creatinine (μmol/L)	97	78	65	60	45	43	42
GFR (mL/minute)	63	82	102	109	120	122	123
D-D (mg/L)	> 30	6.06	13.83	> 30	12.97	10.44	12.12
APTT (second)	23.6	60.6	48.2	35.9	38	21.9	24.7
Blood gas analysis
PH	7.326	7.385	7.513	7.399	7.441	7.432	7.449
Lactic acid (mmoL/L)	10.1	3.1	1.3	1.1	1	0.8	0.6
HCO3- (mmoL/L)	17.1	23	37.7	27.5	23.6	24.8	25.1
P/F (mmHg)	192	328	175	429	475	501	474
Myocardial enzyme
CK (U/L)	152	308	1255	2423	1534	716	357
CK-MB (ng/mL)	4.22	22.50	20.94	25.95	26.56	12.09	9.98
CTnI (μg/L)	0.281	4.287	1.119	0.73	0.614	-	-
NT-proBNP (pg/mL)	302	5665	7240	6566	5717	-	-

April 12: Line after extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon counterpulsation (IABP); April 15: The third day of ECMO and IABP use; April 18: After ECMO withdrawal; April 21: Before IABP withdrawal; April 24: After IABP withdrawal; April 25: Vital signs are stable, various indicators have improved, and it is ready to be transferred to the general ward for surgical treatment. WBC: White blood cell; Hb: Hemoglobin; Plt: Platelet; PCT: Procalcitonin; GFR: Glomerular filtration rate; D-D: D-dimer; APTT: Activated partial thromboplastin time; P/F: Oxygenation index; CK: Creatine kinase; CK-MB: Creatine kinase isoenzyme; CTnI: High-sensitivity troponin I; NT-proBNP: N-terminal pro-B-type natriuretic peptide.

Table 2 Cardiac Doppler ultrasound results

Time	LVEF	Left ventricular outflow tract V-max (m/second)
First day	40%-50%	-
Third day	50%	-
Before withdrawing ECMO	56%-62%	1.7-1.9
After withdrawing ECMO	55%-60%	2
Before withdrawing IABP	65%	1.9
After withdrawing IABP	62%	1.8

LVEF: Left ventricular ejection fraction; ECMO: Extracorporeal membrane oxygenation; IABP: Intra-aortic balloon counterpulsation.

Table 3 Hemodynamics

Hemodynamics	April 12	April 13	April 14	April 15	April 16	April 17	April 18	April 19	April 20	April 21
NIBP (mmHg)	152/87	104/61	115/63	72/62	181/93	170/89	158/122	130/82	134/82	121/70
NIBPm (mmHg)	109	77	80	65	138	116	146	99	101	87
CVP	11.7	6.8	6.5	7.3	6.8	7.0	12.9	12.2	5.2	12.8

The table records the patient’s blood pressure and central venous pressure measured at 6 am every day. NIBP: Invasive blood pressure; NIBPm: Invasive means blood pressure; CVP: Central venous pressure.

Table 4 Blood and urine catecholamines results

Laboratory tests		Time
		The first time	The second time	The third time
Blood	3-MT (pg/mL)	144.1	23.9	< 12
	DA (pg/mL)	442.3	< 18	23.4
	NE (pg/mL)	3697.6	1712.6	1242.9
	E (pg/mL)	> 2000	> 2000	> 2000
	NMN (pg/mL)	> 2000	> 2000	424.6
	MN (pg/mL)	> 1000	> 1000	> 1000
Urine	NMN (μg/24 hours)	-	2027.9	1107.2
	MN (μg/24 hours)	-	> 2504	3842
	DA (μg/24 hours)	-	129.9	181.7
	E (μg/24 hours)	-	> 250.4	> 420
	NE (μg/24 hours)	-	3194.8	239.9
	HVA (mg/24 hours)	-	5.3	9.5
	VMA/24 hours (mg/24 hours)	-	42.88	22.58
	3-MT (μg/24 hours)	-	144.9	301.3
	PTH (Pmol/mL)	58.410
Blood cortisol (nmol/mL)	8 am	619.91
	12 am	687.53
ACTH (pg/mL)	8 am	11.4
	12 am	18.52
24 hours urine cortisol (μg/24 hours)		7857.56
Aldosterone (pg/mL)		174.44

ACTH: Adreno-cortico-tropic-hormone; 3-MT: 3-Methoxytyramine; DA: Dopamine; NE: Noradrenaline; E: Epinephrine; NMN: Normetanephrine; MN: Metanephrine; HVA: Herpes virus allele; VMA: Vanilmandelic acid; PTH: Parathyroid hormone.