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anesthesia mediastinal mass

Hiroki Nishine, Hiromi Muraoka, Takeo Inoue, Teruomi Miyazawa, Masamichi Mineshita
Stenting at the flow-limiting segment can improve the ventilation-perfusion ratio in patients with central airway stenosis. However, there is no quantitative examination for assessing the perfusion status during interventional bronchoscopy. Intrabronchial capnography can estimate regional gas exchange by measuring carbon dioxide concentration. We herein report a case of bilateral bronchial stenosis where stenting was able to improve ventilation-perfusion ratio using intrabronchial capnography. A 44-year-old man was admitted to our institution with orthopnea...
April 20, 2018: Respiration; International Review of Thoracic Diseases
Yingming Xiang, Shaosong Tu, Fangbiao Zhang
RATIONALE: Mediastinal solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms. Complete resection is considered as the effective treatment and the prognosis is quite good. Rapid metastasis after surgery is extremely rare. PATIENT CONCERNS: In this case report we describe a 42-year-old man who present with a mediastinal malignant SFTs. Enhanced computed tomography of chest revealed a 4.5 × 4.0-cm mass in the anterior mediastinum. DIAGNOSES: The tumor is composed of massive proliferation of atypical spindle cells...
December 2017: Medicine (Baltimore)
Mark R Katlic
BACKGROUND: General anesthesia and endotracheal intubation are a luxury rather than a necessity for many video-assisted thoracic surgery (VATS) operations. Twenty-three years ago, I began using local anesthesia and sedation for pleural disease and subsequently, for pericardial and lung disease. STUDY DESIGN: The records of all patients undergoing VATS using local anesthesia and sedation at hospitals of the Geisinger Health System (Danville and Wilkes-Barre, PA), from June 1, 2002 to June 30, 2011, and the Lifebridge Health System (Baltimore, MD) from July 1, 2011 to March 1, 2017, were retrospectively reviewed...
January 2018: Journal of the American College of Surgeons
Renu Sinha, Anjan Trikha, Rajkumar Subramanian
A 15-year-old boy, weighing 45 kg, 160 cm height with large anterior mediastinal mass and significant tracheal narrowing was scheduled for thoracotomy and excision of the mass. He had a history of progressive dyspnea, inability to lie supine, and a right upper hemithorax mass 13 cm × 13 cm × 11 cm as evident on a computerized tomography with significant compression of the trachea and right main stem bronchus. Inhalational induction was carried out using sevoflurane with 100% oxygen. After achieving adequate depth of anesthesia with the maintenance of spontaneous respiration with oxygen and sevoflurane (minimum alveolar concentration 1...
October 2017: Saudi Journal of Anaesthesia
M Aguilera-Pujabet, G Guillén, N Montferrer, S López-Fernández, J A Molino, J Lloret
AIM: To analyze the current risk of an anesthetic event during surgical acts in pediatric patients with anterior mediastinal masses (AMM) in a tertiary oncology center, using the previously published risk factors to plan the procedure. MATERIALS AND METHODS: Retrospective study (2009-2015) of pediatric patients with AMM who underwent surgical procedures at debut. Published risk factors (symptoms, radiological findings), with special focus on the statistically significant ones, diagnosis, surgical and anesthetic procedure, special measures, and anesthetic events were recorded...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Mathieu Raillard, Pamela J Murison, Ivan P Doran
The anesthetic management of a pediatric pug for removal of a mediastinal mass is described. During recovery from anesthesia, the dog's respiratory pattern was compatible with bilateral diaphragmatic paralysis. Incidence, complications, possible treatments of phrenic nerve injury, problems of long-term mechanical ventilation, and alternative case management are discussed.
March 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
Adam C Adler, Emily R Schwartz, Jennifer M Waters, Paul A Stricker
Anesthetic management of the child with an anterior mediastinal mass is challenging. The surgical/procedural goal typically is to obtain a definitive tissue diagnosis to guide treatment; the safest approach to anesthesia is often one that alters cardiorespiratory physiology the least. In severe cases, this may translate to little or no systemic sedatives/analgesics. Distraction techniques, designed to shift attention away from procedure-related pain (such as counting, listening to music, non-procedure-related talk), may be of great benefit, allowing for avoidance of pharmaceuticals...
December 2016: Journal of Clinical Anesthesia
Nina Sulen, Barbara Petani, Ivan Bacić, Domagoj Morović
Patients with mediastinal masses present unique challenge to anesthesiologists. Patients with anterior mediastinal masses have well documented cases of respiratory or cardiovascular collapse during anesthesia and in postoperative period. Masses in the posterior mediastinum have been traditionally regarded to carry a significantly lower risk of anesthesia related complications but cases of near fatal cardiorespiratory complications have been reported. We describe anesthetic management of a patient with posterior mediastinal mass compressing the trachea and the left main bronchus presented for left thoracotomy and tumor excision...
March 2016: Acta Clinica Croatica
Suman Rajagopalan, Mark Harbott, Jaime Ortiz, Venkata Bandi
The anesthetic management of patients with large mediastinal masses can be complicated due to the pressure effects of the mass on the airway or major vessels. We present the successful anesthetic management of a 64-year-old female with a large mediastinal mass that encroached on the great vessels and compressed the trachea. A tracheal stent was placed to relieve the tracheal compression under general anesthesia. Spontaneous ventilation was maintained during the perioperative period with the use of a classic laryngeal mask airway...
March 2016: Brazilian Journal of Anesthesiology
Karan Madan, Pramod Garg, Sushil K Kabra, Anant Mohan, Randeep Guleria
Evaluation of mediastinal lymphadenopathy in children is challenging and surgical procedures (mediastinoscopy/thoracotomy) are usually performed wherever tissue sampling is required. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a widely utilized and minimally invasive modality for evaluation of mediastinum (lymphadenopathy, masses, and nodal staging in patients with lung cancer) in adults. Smaller size of pediatric trachea potentially limits the use of EBUS. The EBUS bronchoscope can also be introduced into the esophagus for mediastinal evaluation and sampling, a technique described as transesophageal bronchoscopic ultrasound-guided fine-needle aspiration (EUS-B-FNA)...
October 2015: Journal of Bronchology & Interventional Pulmonology
Mumin Hakim, Candice Burrier, Tarun Bhalla, Vidya T Raman, David P Martin, Olamide Dairo, Joel L Mayerson, Joseph D Tobias
Tumor progression during end-of-life care can lead to significant pain, which at times may be refractory to routine analgesic techniques. Although regional anesthesia is commonly used for postoperative pain care, there is limited experience with its use during home hospice care. We present a 24-year-old male with end-stage metastatic osteosarcoma who required anesthetic care for a right-sided above-the-elbow amputation. The anesthetic management was complicated by the presence of a large mediastinal mass, limited pulmonary reserve, and severe chronic pain with a high preoperative opioid requirement...
2015: Journal of Pain Research
Jared Kevin Pearson, Gee Mei Tan
One of the more challenging cases facing a pediatric anesthesiologist is the management of patients presenting with an anterior mediastinal mass (AMM). Patients with an AMM may have severe cardiopulmonary compromise that can be exacerbated when undergoing general anesthesia. Several case reports have documented cardiopulmonary collapse during induction or maintenance of general anesthesia and even for procedures done without anesthesia. Despite increased understanding and management of these patients, perioperative complications, defined as anything from transient decreases in blood pressure correcting with fluids or mild airway obstruction requiring no intervention, to complete cardiopulmonary collapse, are still estimated to occur during 9% to 20% of anesthetic procedures...
September 2015: Seminars in Cardiothoracic and Vascular Anesthesia
Shannon N Acker, Jacqueline Linton, Gee Mei Tan, Timothy P Garrington, Jennifer Bruny, Joanne M Hilden, Lindsey M Hoffman, David A Partrick
PURPOSE: Anterior mediastinal masses (AMM) pose a diagnostic challenge to surgeons, oncologists, anesthesiologists, intensivists, and interventional radiologists as induction of general anesthesia can cause airway obstruction and cardiovascular collapse. We hypothesized that in the majority of patients, diagnosis can be obtained through biopsy of extrathoracic tissue. METHODS: We performed a retrospective review of all patients in the solid tumor oncology clinic with a diagnosis of AMM between 2002 and 2012 including preoperative evaluation and management prior to obtaining a tissue diagnosis, clinical course and complications...
May 2015: Journal of Pediatric Surgery
S D Popov, N A Il'ina
Inflammatory myofibroblastic tumor is a neoplasm of intermediate biological potential, a marked inflammatory component, and characteristic genetic changes. Once it was identified as an independent nosological entity from a rather heterogeneous group of inflammatory pseudotumors. This paper describes a case of inflammatory myofibroblastic tumor of the chest in a child, by discussing the criteria for differential diagnosis in the use of up-to-date radiology techniques. When thoracic neoplasms are detected, it is necessary to determine their site and the most likely origin organ as exactly as possible and to assess the X-ray pattern of the pathological process...
November 2013: Vestnik Rentgenologii i Radiologii
Yatish Bevinaguddaiah, Shivakumar Shivanna, Vinayak Seenappa Pujari, Manjunath Abloodu Chikkapillappa
Anterior mediastinal mass is a rare pathology that presents considerable anesthetic challenges due to cardiopulmonary compromise. We present a case that was referred to us in the third trimester of pregnancy with severe breathlessness and orthopnea. An elective cesarean delivery was performed under combined spinal epidural anesthesia with a favorable outcome. We discuss the perioperative considerations in these patients with a review of the literature.
October 2014: Saudi Journal of Anaesthesia
Sameh M Said, Brian J Telesz, George Makdisi, Fernando J Quevedo, Rakesh M Suri, Mark S Allen, William J Mauermann
Management of a large mediastinal mass causing respiratory and hemodynamic compromise represents a major challenge during induction of anesthesia and surgical resection. The hemodynamic changes associated with anesthetic induction and initiation of positive-pressure ventilation can lead to acute hemodynamic collapse or inability to ventilate, or both. Initiation of cardiopulmonary bypass before anesthetic induction represents a safe alternative. We present a 37-year-old woman who underwent successful resection of a large anterior mediastinal mass through sternotomy...
October 2014: Annals of Thoracic Surgery
Jeounghyuk Lee, Yong Chul Rim, Junyong In
Perioperative management of patients with an anterior mediastinal mass is difficult. We present a 35-year-old woman who showed delayed compression of the carina and left main bronchus despite no preoperative respiratory signs, symptoms, or radiologic findings due to an anterior mediastinal mass and uneventful stepwise induction of general anesthesia. Even use of a fiberoptic bronchoscope (FB) after induction of anesthesia was not helpful to predict delayed compression of the airway. Therefore, the anesthesiologist and the cardiothoracic surgeon must prepare for unexpected delayed compression of the airway, even in low risk patients who are asymptomatic or mildly symptomatic without postural symptoms or radiographic evidence of significant compression of structures...
June 2014: Journal of Thoracic Disease
Abdul Hamid Alraiyes, Khalid Alokla, Fayez Kheir, Jaime Palomino
BACKGROUND: A right-sided aortic arch (RAA) is a rare anomaly of the cardiovascular system, presenting in only 0.1% of the population. In some reported cases, RAA is accompanied by another cyanotic vascular anomaly such as tetralogy of Fallot, and patients with such anomalies are usually diagnosed in fetal life or early childhood. Most patients are asymptomatic if the RAA presents individually. CASE REPORT: We report the case of a 27-year-old African American man who presented to urgent care with 3 weeks of progressive dry cough with mild shortness of breath, low-grade fevers, and night sweats...
2014: Ochsner Journal
Michael Fabbro, Prakash A Patel, Harish Ramakrishna, Elizabeth Valentine, Edward A Ochroch, John G Agoustides
No abstract text is available yet for this article.
June 2014: Journal of Cardiothoracic and Vascular Anesthesia
Prakash Kumar Dubey
A 3-month-old male child underwent uneventful inguinal herniotomy under general anesthesia. After extubation, airway obstruction followed by pulmonary edema appeared for which the baby was reintubated and ventilated. The baby made a complete recovery and extubated after about 2 h. A post-operative computed tomography scan revealed a posterior mediastinal cystic mass abutting the tracheal bifurcation. Presumably, extrinsic compression by the mass on the tracheal bifurcation led to the development of negative pressure pulmonary edema...
April 2014: Annals of Cardiac Anaesthesia
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