Anaesthetic outcome and predictive risk factors in children with mediastinal tumours.
OBJECTIVE
The aims were to identify and test the significance of specific factors associated with risks for anaesthesia in children with mediastinal tumours.


METHODS
Clinical information was retrospectively collected from the records of 63 children presented with mediastinal tumour (1964-2002) in a regional Paediatric Oncology centre and correlated with the type and outcome of anaesthesia, using non-parametric analyses.


RESULTS
Thirteen patients had local anaesthesia or sedation for diagnostic procedures and none developed any complication. Fifty children received general anaesthesia (GA) for diagnostic investigations or tumour resection. Two patients were excluded from the analysis because of treatment prior to GA. Problems with intubation, ventilation and cardiovascular collapse were encountered in 7 of 48 (15%) patients and this resulted in tracheostomy in one patient and death in 2 other cases. When compared with the 41 uncomplicated cases, the presence of at least 3 respiratory symptoms/signs, tracheal and vascular compression, and infection significantly increased the risk of GA. Of these, tracheal compression remained the strongest predictive factor.


CONCLUSIONS
Decision to postpone GA should be considered if all these risk factors (tracheal compression, vascular compression, the presence of at least three respiratory symptoms/signs) are present in the same patient.
Ng
A
A
Department of Oncology, Birmingham Children's Hospital, Birmingham, United Kingdom. antng@blueyonder.co.uk
Bennett
J
J
Bromley
P
P
Davies
P
P
Morland
B
B
D000293:Adolescent; D000740:Anemia / Q000150:complications; D000768:Anesthesia, General / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007239:Infections / Q000150:complications; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000503:physiopathology*; D012131:Respiratory Insufficiency / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012769:Shock / Q000209:etiology; D014139:Tracheostomy