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

• DOI: 10.1213/ane.0b013e31821f9c95
• Publication Date: 2011-05-19T07:53:54Z
• Authors: Jeffrey C. Gardner; Roger L. Royster
• Keywords: Male; Pulmonary Atelectasis; Biopsy; Hodgkin Disease; Mediastinal Neoplasms; Respiration, Artificial; 3. Good health; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Bronchoscopy; Bradycardia; Intubation, Intratracheal; Respiratory Mechanics; Humans; Anesthesia; Splanchnic Circulation; Anesthesia, Inhalation; Intraoperative Complications

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 inhaled anesthesia an endotracheal tube. Given sudden profound presentation of cardiopulmonary collapse, rigid bronchoscopy should be immediately available facilitate life-saving ventilation. Though repositioning pediatric patient lateral or prone has been reported reestablish patency, this maneuver limited benefit population because a more ossified developed chest wall. Lastly, if high-risk requires general anesthetic, strong consideration given preinduction placement femoral bypass cannulae availability initiate bypass.