前纵隔肿瘤心肺骤停的抢救：病例报告及文献复习
Rescue of cardiopulmonary collapse in anterior mediastinal tumor: case presentation and review of literature.
作者信息
Huang Yi-Ling, Yang Ming-Chun, Huang Chi-Hsiang, Wang Ching-Chia, Wu En-Ting, Huang Shu-Chien, Jou Shiann-Tarng, Chen Jin-Shing, Ko Wen-Je
机构信息
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, Taipei, Taiwan.
出版信息
Pediatr Emerg Care. 2010 Apr;26(4):296-8. doi: 10.1097/PEC.0b013e3181d6daf0.
BACKGROUND
Anterior mediastinal tumors in pediatric patients may cause severe cardiorespiratory compromise and sudden collapse, especially when anesthesia or analgesic is required.
METHOD
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.
背景
小儿前纵隔肿瘤可能导致严重的心肺功能不全和突然虚脱，尤其是在需要麻醉或镇痛时。
方法
我们报告一名15岁男孩，患有巨大的前纵隔肿瘤，该肿瘤导致右肺动脉和左主支气管完全闭塞，即完全的通气-灌注不匹配。注射哌替啶后发生心肺衰竭，并开始进行体外膜肺氧合（ECMO）治疗。
结果
然后我们置入支气管支架以恢复气道通畅，并在ECMO支持下进行化疗。40小时后撤除体外膜肺氧合。然而，患者在入院9天后死于中性粒细胞减少性败血症。
结论
我们强调了前纵隔肿瘤压迫肺动脉和对侧支气管的灾难性后果，以及使用ECMO作为抢救措施。
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