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Abstract
BackgroundPatients with an anterior mediastinal mass are at risk of perioperative respiratory collapse.Case presentationA 74-year-old woman with a large anterior mediastinal mass that led to partial tracheal collapse (shortest diameter, 1.3 mm) was scheduled for tracheobronchial balloon dilation and stent placement under general anesthesia. Although veno-venous extracorporeal membrane oxygenation (V-V ECMO) had been established, maximum flow was limited to 1.6 L/min, and general anesthesia induction was followed by hypoxia probably due to inadequate ventilation. A flexible bronchoscope was inserted through the tracheal lumen that was being compressed by the anterior mass; this not only increased tracheal patency but also enabled positive pressure ventilation and resulted in recovery from hypoxia. Scheduled procedures were successfully performed without complications.ConclusionWe describe a case wherein tracheal patency was transiently maintained by inserting a flexible bronchoscope in a patient with an anterior mediastinal mass.
Highlights
Patients with an anterior mediastinal mass are at risk of perioperative respiratory collapse.Case presentation: A 74-year-old woman with a large anterior mediastinal mass that led to partial tracheal collapse was scheduled for tracheobronchial balloon dilation and stent placement under general anesthesia
We describe a case wherein tracheal patency was transiently maintained by inserting a flexible bronchoscope in a patient with an anterior mediastinal mass
We describe a case where tracheal patency was transiently maintained by inserting a flexible bronchoscope in a patient with a narrowed trachea due to the presence of an anterior mediastinal mass
Summary
We describe a case where tracheal patency was transiently maintained by inserting a flexible bronchoscope in a patient with a trachea compressed by the presence of an anterior mediastinal mass. The patient showed decreased oxygenation after anesthesia induction despite V-V ECMO initiation. Ethics approval and consent to participate In our institution, IRB approval is not required for a case report. Consent for publication Written informed consent was obtained from the patient for publication of this case report. Competing interests All authors report no conflict of interest. Author details 1Department of Anesthesiology, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, Fukushima 960-1295, Japan. Author details 1Department of Anesthesiology, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, Fukushima 960-1295, Japan. 2Surgical Operation Department, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, Fukushima 960-1295, Japan
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