Airway Collapse with an Anterior Mediastinal Mass Despite Spontaneous Ventilation in an Adult

作者：Gardner Jeffrey C^*; Royster Roger L

来源：Anesthesia and Analgesia, 2011, 113(2): 239-242.

DOI：10.1213/ANE.0b013e31821f9c95

Patients with anterior mediastinal masses are at increased risk for perioperative complications. Our case demonstrates that airway collapse and inability to ventilate may occur in the asymptomatic adult despite spontaneous ventilation with inhaled anesthesia and an endotracheal tube. Given the sudden and profound presentation of cardiopulmonary collapse, rigid bronchoscopy should be immediately available to facilitate life-saving ventilation. Though repositioning the pediatric patient lateral or prone has been reported to reestablish airway patency, this maneuver may be of limited benefit in the adult population because of a more ossified and developed chest wall. Lastly, if a high-risk patient requires a general anesthetic, strong consideration should be given to preinduction placement of femoral cardiopulmonary bypass cannulae and the availability to immediately initiate cardiopulmonary bypass. (Anesth Analg 2011;113:239-42)

• 出版日期2011-8