Anest. intenziv. Med. 2016;27(6):390-394

Critical airway obstruction during general anaesthesia caused by anterior mediastinal mass managed by ECMO and tracheobronchial stentingCase Report

K. Netri^1,*, J. Votruba², J. Rulíšek¹, L. Kraus¹, P. Michálek^1,3

¹ Klinika anesteziologie, resuscitace a intenzivní medicíny 1. LF UK a Všeobecné fakultní nemocnice, Praha

² První klinika tuberkulózy a respiračních nemocí 1. LF UK a Všeobecné fakultní nemocnice, Praha

³ Department of Anaesthetics, Antrim Area Hospital, Antrim, Spojené království Velké Británie a Severního Irska

Acute compression of the trachea and the large bronchi during anaesthesia can very quickly lead to development of life-threatening hypoxia, if alternative methods of oxygenation are not established immediately. The case report describes the course and management of a sudden collapse of the lower part of the trachea and main bronchi in a young patient who was indicated for the extirpation of deep cervical lymph nodes under general anesthesia. He developed very high inspiratory pressures with a significant reduction in lung volumes and desaturation, which was caused by compression of the airway due to a lymphoma mass in the anterior mediastinum. In order to improve oxygenation, a suction catheter was inserted endobronchially and the patient was ventilated through it. He was then connected to the ECMO device and definitive solution of the stenosis was achieved with a "Y" stent inserted into the trachea. Three years after the procedure, the underlying disease is in remission and the patient is in good health.

Keywords: anterior mediastinal mass; tracheal obstruction; extracorporeal membrane oxygenation (ECMO); stenting

Received: July 17, 2016; Accepted: August 15, 2016; Published: December 1, 2016  Show citation