title: Life-threatening presentation of mediastinal neoplasms: report on 7 consecutive pediatric patients.
abstract: BACKGROUND
  Cases of respiratory failure at presentation in children with anterior mediastinal malignancies can be very challenging for clinicians. Seven consecutive children presenting with superior mediastinal syndrome are reported needing urgent critical care approach.
  
  
  METHODS
  Seven children (age range from 0.8 to 14 years; mean, 4.5 years) suffered from critical mediastinal neoplasms. Clinical presentation, laboratory findings, treatment, and outcome are discussed.
  
  
  METHODS
  a tertiary-care 6-bed medical and surgical pediatric intensive care in a university hospital. Interventions included emergency management, resuscitation and intensive care admission, and diagnostic and therapeutic procedures.
  
  
  RESULTS
  All cases showed a respiratory compromise and underwent ventilatory and/or cardiovascular support. Two patients needed renal replacement therapy. Pediatric Intensive Care Unit discharge was achieved in all patients.
  
  
  CONCLUSIONS
  Critical or extreme presentation of mediastinal neoplasms does not preclude a good clinical outcome: an intensive care approach is essential to allow patient recovery and effective antineoplastic therapy administration.
authors.affiliation: Pediatric Intensive Care Unit, Catholic University Medical School, 00168 Rome, Italy. xoct01@yahoo.it
authors.forename: Marco
authors.initials: M
authors.lastname: Piastra
authors.forename: Antonio
authors.initials: A
authors.lastname: Ruggiero
authors.forename: Elena
authors.initials: E
authors.lastname: Caresta
authors.forename: Antonio
authors.initials: A
authors.lastname: Chiaretti
authors.forename: Silvia
authors.initials: S
authors.lastname: Pulitano
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Polidori
authors.forename: Riccardo
authors.initials: R
authors.lastname: Riccardi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000209:etiology; D003422:Critical Care / Q000379:methods; D004417:Dyspnea / Q000209:etiology; D004487:Edema / Q000209:etiology; D004635:Emergency Medicine / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D016399:Lymphoma, T-Cell / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008479:Mediastinal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D018202:Pulmonary Blastoma / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D012135:Respiratory Sounds / Q000209:etiology; D013724:Teratoma / Q000150:complications / Q000175:diagnosis / Q000628:therapy