PDF(Pubmed)
Abstract：
UNASSIGNED: Perioperative anesthetic management in cases of severe airway obstruction with positional symptoms can be associated with difficulties in ventilation or intubation, with a risk of acute respiratory decompensation at every stage of anesthesia.
METHODS: Here we describe the anesthetic management of an 18-year-old woman with a mature teratoma who presented with progressive exertional dyspnea that was aggravated in the supine position in the operating room. After tracheal intubation, the tidal volume decreased, airway pressure increased, and pet CO2 grew beyond 105 mmHg without oxygen desaturation, prompting a femoro-femoral cardio-pulmonary bypass.
UNASSIGNED: Cardio-pulmonary bypass (CPB) can facilitate tumor dissection by safely deflating the lungs and retracting the heart, enhancing exposure and reducing risks of hemodynamic or respiratory complications. However, systemic heparinization may increase complications, necessitating a preoperative risk assessment.
CONCLUSIONS: Preoperative management of large mediastinal masses requires careful attention to tumor anatomical details and relationships with surrounding structures. Preoperative preparation includes multimodality imaging and multidisciplinary team discussions to assess MMS risk, requiring specialized center management.
METHODS: Here we describe the anesthetic management of an 18-year-old woman with a mature teratoma who presented with progressive exertional dyspnea that was aggravated in the supine position in the operating room. After tracheal intubation, the tidal volume decreased, airway pressure increased, and pet CO2 grew beyond 105 mmHg without oxygen desaturation, prompting a femoro-femoral cardio-pulmonary bypass.
UNASSIGNED: Cardio-pulmonary bypass (CPB) can facilitate tumor dissection by safely deflating the lungs and retracting the heart, enhancing exposure and reducing risks of hemodynamic or respiratory complications. However, systemic heparinization may increase complications, necessitating a preoperative risk assessment.
CONCLUSIONS: Preoperative management of large mediastinal masses requires careful attention to tumor anatomical details and relationships with surrounding structures. Preoperative preparation includes multimodality imaging and multidisciplinary team discussions to assess MMS risk, requiring specialized center management.
摘要：
■在有位置症状的严重气道阻塞的情况下，围手术期麻醉管理可能与通气或插管困难有关，在麻醉的每个阶段都有急性呼吸代偿失调的风险。
方法：在这里，我们描述了一名患有成熟畸胎瘤的18岁女性的麻醉管理，该女性表现为进行性劳力性呼吸困难，在手术室仰卧位加重。气管插管后,潮气量减少,气道压力升高,在没有氧气饱和的情况下，宠物二氧化碳超过105mmHg，提示股-股心肺分流术。
■心肺旁路术（CPB）可以通过安全地缩小肺部和收缩心脏来促进肿瘤解剖，增强暴露并降低血液动力学或呼吸系统并发症的风险。然而,全身性肝素化可能会增加并发症，需要进行术前风险评估。
结论：大型纵隔肿块的术前处理需要仔细注意肿瘤的解剖细节以及与周围结构的关系。术前准备包括多模态成像和多学科小组讨论，以评估MMS风险。需要专门的中心管理。
方法：在这里，我们描述了一名患有成熟畸胎瘤的18岁女性的麻醉管理，该女性表现为进行性劳力性呼吸困难，在手术室仰卧位加重。气管插管后,潮气量减少,气道压力升高,在没有氧气饱和的情况下，宠物二氧化碳超过105mmHg，提示股-股心肺分流术。
■心肺旁路术（CPB）可以通过安全地缩小肺部和收缩心脏来促进肿瘤解剖，增强暴露并降低血液动力学或呼吸系统并发症的风险。然而,全身性肝素化可能会增加并发症，需要进行术前风险评估。
结论：大型纵隔肿块的术前处理需要仔细注意肿瘤的解剖细节以及与周围结构的关系。术前准备包括多模态成像和多学科小组讨论，以评估MMS风险。需要专门的中心管理。
