Rescue of cardiopulmonary collapse in anterior mediastinal tumor: case presentation and review of literature.
BACKGROUND
Anterior mediastinal tumors in pediatric patients may cause severe cardiorespiratory compromise and sudden collapse, especially when anesthesia or analgesic is required.


METHODS
We report a 15-year-old boy with a huge anterior mediastinal tumor that caused complete obliteration of right pulmonary artery and left bronchus, that is, complete ventilation-perfusion mismatch. Cardiopulmonary collapse happened after meperidine injection, and extracorporeal membrane oxygenation (ECMO) was instituted.


RESULTS
We then put bronchial stents to restore airway patency and proceeded chemotherapy under ECMO support. Extracorporeal membrane oxygenation was removed 40 hours later. However, the patient died of neutropenic sepsis 9 days after admission.


CONCLUSIONS
We emphasized the devastating consequences of anterior mediastinal tumor compression on the pulmonary artery and the contralateral-side bronchus and the use of ECMO as a rescue.
Huang
Yi-Ling
YL
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, Taipei, Taiwan.
Yang
Ming-Chun
MC
Huang
Chi-Hsiang
CH
Wang
Ching-Chia
CC
Wu
En-Ting
ET
Huang
Shu-Chien
SC
Jou
Shiann-Tarng
ST
Chen
Jin-Shing
JS
Ko
Wen-Je
WJ
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage / Q000009:adverse effects; D000293:Adolescent; D000402:Airway Obstruction / Q000209:etiology*; D001157:Arterial Occlusive Diseases / Q000209:etiology* / Q000628:therapy; D001980:Bronchi / Q000601:surgery; D015199:Extracorporeal Membrane Oxygenation; D006323:Heart Arrest / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000150:complications*; D008614:Meperidine / Q000008:administration & dosage / Q000009:adverse effects; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011859:Radiography; D015607:Stents
D000759:Adjuvants, Anesthesia; D008614:Meperidine