FloTrac-guided real-time hemodynamic management for pheochromocytoma resection in a pediatric patient: a case report

Pheochromocytoma remains one of the most challenging endocrine tumors for anesthesiologists, primarily due to catecholamine-induced hemodynamic instability characterized by unpredictable and profound fluctuations. This challenge is further compounded in pediatric patients, whose circulatory reserve, autonomic reactivity, and vascular compliance differ substantially from those of adults. This report details the case of a 14-year-old boy diagnosed with a left adrenal pheochromocytoma who underwent laparoscopic adrenalectomy. Real-time hemodynamic monitoring was performed using the FloTrac/EV1000 platform. In addition to standard parameters, such as arterial blood pressure (ABP) and heart rate (HR), we integrated advanced hemodynamic indices derived from arterial waveform analysis, including cardiac output (CO), cardiac index (CI), stroke volume (SV), stroke volume variation (SVV), pulse pressure variation (PPV), and systemic vascular resistance (SVR). This case report suggested that FloTrac-guided advanced hemodynamic monitoring may facilitate hemodynamic management during pediatric pheochromocytoma surgery.