Hemodynamic Effects of Orally Administered Delta-ALA During Radical Prostatectomy

Overview

Journal World J Urol

Specialty Urology

Date 2011 Nov 29

PMID 22120180

Citations 4

Authors

Volker Eichhorn

Alexander Maerz

Georg Salomon

Irmgard F Blanc

Daniel A Reuter

Alwin E Goetz

Affiliations

Soon will be listed here.

Abstract

Purpose: We investigated hemodynamics in patients receiving delta-Aminolevulinic acid (delta-ALA) to visualize tumor margins prior to radical retro pubic prostatectomy.

Patients: Twenty patients undergoing elective open radical retro pubic prostatectomy (RRP).

Methods: Cohort observational study. Ten patients receiving 20 mg/kg of delta-ALA orally prior to surgery (delta-ALA) and 10 patients undergoing RRP without the application of delta-ALA served as a retrospectively matched cohort (CONTROL).

Measurements: Changes in heart rate (HR), mean arterial blood pressure (MAP), and functional hemodynamic parameters were assessed by electrocardiogram, non-invasive and invasive blood pressure monitoring plus transcardiopulmonary thermodilution.

Results: Patients of both groups did not differ in means of age, body mass index, or ASA classification. During surgery, HR and MAP did not differ significantly between both groups. Also, the amount of IV crystalloids and colloids did not differ significantly. In contrast, the amount of vasopressor necessary to maintain MAP within the target range of 70-90 mmHg was significantly higher in delta-ALA when compared to CONTROL (0.08 ± 0.04 μg/kg/min (delta-ALA) vs. 0.03 ± 0.02 μg/kg/min (CONTROL); P < 0.01). Immediately after surgery, patients of delta-ALA showed a significantly higher heart rate (82 ± 18 min(-1) vs. 67 ± 9 min(-1); P < 0.05) compared to patients of CONTROL. Cardiac index, global end-diastolic volume index, and extravascular lung water index were significantly higher after surgery, when compared to baseline values (P < 0.05).

Conclusions: Orally administered delta-ALA prior to open radical prostatectomy induces hemodynamic instability in the perioperative period requiring vasopressor support. Further, an increase of extravascular lung water points toward an increased vascular permeability induced by delta-ALA.

Citing Articles

Preoperative antihypertensives and hypotension during bladder tumor resection with oral 5-aminolevulinic acid administration.

Kondo Y, Mihara T, Yoshikawa N, Echigo N, Nagamine Y, Goto T PLoS One. 2025; 20(2):e0319413.

PMID: 39992902 PMC: 11849823. DOI: 10.1371/journal.pone.0319413.

Severe hypotension and postoperative cardiac arrest caused by 5-aminolevulinic acid: a case report.

Miyazaki T, Taguchi S, Obata N, Mizobuchi S J Med Case Rep. 2024; 18(1):264.

PMID: 38811941 PMC: 11137901. DOI: 10.1186/s13256-024-04589-x.

Incidence of perioperative hypotension in patients undergoing transurethral resection of bladder tumor after oral 5-aminolevulinic acid administration: a retrospective multicenter cohort study.

Kondo Y, Nagamine Y, Yoshikawa N, Echigo N, Kida T, Sumitomo M J Anesth. 2023; 37(5):703-713.

PMID: 37422859 DOI: 10.1007/s00540-023-03222-3.

Pronounced haemodynamic changes during and after robotic-assisted laparoscopic prostatectomy: a prospective observational study.

Pawlik M, Prasser C, Zeman F, Harth M, Burger M, Denzinger S BMJ Open. 2020; 10(10):e038045.

PMID: 33020097 PMC: 7537432. DOI: 10.1136/bmjopen-2020-038045.

5-Aminolevulinic acid-induced severe hypotension during transurethral resection of a bladder tumor: a case report.

Yatabe T, Marie S, Fukuhara H, Karashima T, Inoue K, Yokoyama M JA Clin Rep. 2020; 5(1):58.

PMID: 32025993 PMC: 6967328. DOI: 10.1186/s40981-019-0279-1.

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