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Abstract
IntroductionA 20-year-old man with a reported history of asthma presented to the emergency department in cardiac arrest presumed to be caused by respiratory failure.Case ReportThe patient was discovered to have central airway obstruction and concomitant superior vena cava compression caused by a large mediastinal mass—a condition termed mediastinal mass syndrome. While the patient regained spontaneous circulation after endotracheal intubation, he was challenging to ventilate requiring escalating interventions to maintain adequate ventilation.ConclusionWe describe complications of mediastinal mass syndrome and an approach to resuscitation, including ventilator adjustments, patient repositioning, double-lumen endotracheal tubes, specialty consultation, and extracorporeal life support.
Highlights
A 20-year-old man with a reported history of asthma presented to the emergency department in cardiac arrest presumed to be caused by respiratory failure.Case Report: The patient was discovered to have central airway obstruction and concomitant superior vena cava compression caused by a large mediastinal mass—a condition termed mediastinal mass syndrome
We describe complications of mediastinal mass syndrome and an approach to resuscitation, including ventilator adjustments, patient repositioning, double-lumen endotracheal tubes, specialty consultation, and extracorporeal life support. [Clin Pract Cases Emerg Med. 2021;5(1):62–65.]
Compression of the vena cava may result in superior vena cava (SVC) syndrome, which is characterized by intermittent swelling of the face and oropharyngeal structures, facial rubor, and/or venous congestion
Summary
A 20-year-old man with a reported history of asthma presented to the emergency department in cardiac arrest presumed to be caused by respiratory failure. Case Report: The patient was discovered to have central airway obstruction and concomitant superior vena cava compression caused by a large mediastinal mass—a condition termed mediastinal mass syndrome. While the patient regained spontaneous circulation after endotracheal intubation, he was challenging to ventilate requiring escalating interventions to maintain adequate ventilation
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