Critical airway obstruction during general anaesthesia caused by anterior mediastinal mass managed by ECMO and tracheobronchial stenting
Abstract
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.