Cryoshock

Criteria: shock triggered by cryoablation (for hepatocellular carcinoma, other tumors)

Frequency: up to 1% of cases

Mechanism: release cytokines (IL-1, IL-6, TNF alpha)

Associations:

(1) volume of tissue being frozen

(2) duration of cryotherapy

(3) complete thaw prior to refreezing and double freeze cycles

Clinical features:

(1) initial cryoreaction (chills, fever, tachycardia, tachypnea)

(2) multi-organ failure with coagulopathy and hypotension

(3) high mortality rate