central venous pressure guided fluid management during anaesthesia of a phaeochromocytoma patient with end stage renal disease

A 42-year-old male with a 2-year history on dialysis for renal failure was admitted for adrenalectomy. we applied central venous catheter for this pheochromocytoma case before the induction of anesthesia. although he had no weight change in his last dialysis, he was suffering severe volume depletion despite high arterial blood pressure. there was deep discrepancy between central venous and arterial blood pressure before and during anesthesia of this patient. we strongly recommend central venous guided fluid management started before the induction of anesthesia in these cases despite controversial studies.