MANAGMENT OF PHENTOLAMINE-RESISTANT PHAEOCHROMOCYTOMA WITH BETA-ADRENERGIC BLOCKADE

Tachyphylaxis following repeated administration of alpha-adrenergic-receptorblocking agents is a troublesome complication, especially duringthe management oo phacochromocytoma. Although it has been indicatedthat tachycardia is a manifestation heta-adrenergic-receptorblocking agent such as propranolol effective in preventing arrhythmias,but it is also of significant value in overcoming tachyphylaxisfollowing repeated adminisration of alpha-adrenergic-receptorblocking agents.     

FATAL HAEMORRHAGE FROM THE INNOMINATE ARTERY AFTER TRACHEOSTOMY

A case of fatal haemorrhage from the innominate artery occurreda week after tracheostomy was performed. Control of the bleedingwas tried unsuccessfully by hyperinflation of the cuff of thetracheostomy tube. The mechanism is erosion of the artery bythe inferior border of the tracheostomy tube. Since the treatmentof massive haemorrhage from the innominate artery is extremelydifficult, the avoidance of low tracheostomies and the use ofshort and properly curved tracheostomy tubes may be effectivein prevention of this fatal complication.