DISCUSSION
This patient experienced cardiogenic shock due to pheochromocytoma
crisis. Early administration of ECMO treatment in the local hospital
with other subsequent treatments were crucial in saving the patient’s
life and improving their survival rate. Unfortunately, ECMO had to be
discontinued because of secondary severe bloodstream infection, possibly
caused by emergency catheterization. To address this, CRRT was used as
it has demonstrated effectiveness in removing toxins and inflammatory
mediators, regulating internal environment and improving circulatory
function in cases of multiple traumas and acute kidney
injury5. Given the high technical requirements, cost,
and patient limitation associated with ECMO, CRRT was continued even
after the patient was transferred to our hospital. The results in Table
1 show that prolonged CRRT treatment gradually decreased norepinephrine
level in the patient’s body. In this case report, CRRT effectively
eliminated catecholamines metabolites. However, the patient developed
sepsis, along with toxins and inflammatory cytokines in the circulation.
During the acute attack, the patient experienced heart, liver, and
kidney damaged, leading to circulatory failure, hemodynamic
fluctuations, and inflammatory cytokine secretion. Table 2-3 reveals a
rapid onset of acid-base imbalance in the internal environment. After
the CRRT treatment, the patient’s serum sodium, potassium, electrolyte
ions, pH, as well as and heart, liver, and kidney function gradually
improved. Those improvements may be attributed to the removal of toxins,
inhibition of the patient’s inflammatory response, and gradually
elimination of catecholamines, related substances, and their
metabolites.