Peripheral Cardiopulmonary Bypass in Two Patients With Symptomatic Tracheal Masses: Perioperative Challenges
| Autor: | Anirudh Elayat, Satyajeet Misra, Chappity Preetam, John S. McNeil, Bikram Kishore Behera, Kunal D. Kotkar, Anindya Nayak, Priyank Tapuria, Randal S. Blank, Rudra Pratap Mahapatra, Satyapriya Mohanty |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology Extracorporeal law.invention 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology law medicine.artery medicine Cardiopulmonary bypass Intubation Intratracheal Humans Child Cardiopulmonary Bypass business.industry Tracheal intubation Perioperative respiratory system Airway obstruction medicine.disease Surgery Airway Obstruction Trachea Anesthesiology and Pain Medicine Tracheal tumor Harlequin syndrome Pulmonary artery Female Tracheal Neoplasms Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of cardiothoracic and vascular anesthesia. 35(5) |
| ISSN: | 1532-8422 |
| Popis: | Tracheal tumors or masses causing critical airway obstruction require resection for symptom relief. However, the location and extent of these tumors or masses often preclude conventional general anesthesia and tracheal intubation. Peripheral cardiopulmonary bypass often is required before anesthetizing these patients. Herein, two cases of patients with tracheal masses, in whom awake peripheral cardiopulmonary bypass was instituted, are reported. The first case was that of an obese male child weighing 102 kg, with tracheal rhinoscleroma, who developed Harlequin, or north-south, syndrome after institution of femorofemoral venoarterial partial cardiopulmonary bypass. The second case was that of a female patient with adenoid cystic carcinoma of the trachea causing near-total central airway occlusion. She had severe pulmonary artery hypertension, which prevented the use of venovenous bypass. Instead, femoral vein-axillary artery venoarterial bypass was established to avoid Harlequin syndrome. Some of the challenges encountered were the development of Harlequin syndrome with risk of myocardial and cerebral ischemia, type and conduct of extracorporeal bypass, choice of monitoring sites, and provision of regional anesthesia for peripheral extracorporeal cannulations. Management of such patients needs frequent troubleshooting and multidisciplinary coordination for a successful surgical outcome. |
| Databáze: | OpenAIRE |
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