Transient maintenance of tracheal patency upon the insertion of a flexible bronchoscope in a patient with an anterior mediastinal mass: a case report.

Abstract

BACKGROUND:

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 (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.

CONCLUSION:

We describe a case wherein tracheal patency was transiently maintained by inserting a flexible bronchoscope in a patient with an anterior mediastinal mass.

• Authors: Takayuki Hasegawa, Shinju Obara, Rieko Oishi, Satsuki Shirota, Jun Honda, Shin Kurosawa
• Journal: JA clinical reports (JA Clin Rep) Vol. 7 Issue 1 Pg. 39 (Apr 29 2021) ISSN: 2363-9024 [Electronic] Germany
• PMID: 33928455 (Publication Type: Journal Article)