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Ventilation through placing the endotracheal tube passed down beyond the obstruction during general anesthesia in patient with mediastinal mass
Med Biol Sci Eng 2019;2(1):17-21
Published online January 31, 2019
© 2019 Medical Biological Science and Engineering.

Dong-soo Han, Sue Youn Park, Youngwook You, Jeeyun Rhee, Dae Hoon Kim, Seongtae Jeong

Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Korea
Correspondence to: Seongtae Jeong
Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea
Tel: +82-62-220-6893 Fax: +82-62-232-6294 E-mail: anesjst@jnu.ac.kr
ORCID: http://orcid.org/0000-0002-6245-9779
Received August 17, 2018; Revised August 24, 2018; Accepted August 24, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Most common and featured complication in anesthetized patient with mediastinal mass is tracheobronchial compression distal to endotracheal tube. Because of reduced lung volume, relaxation of bronchial smooth muscle and eliminated diaphragm movement, general anesthesia exacerbate extrinsic intrathoracic airway compression. Once trachea or bronchus is collapsed, it is usually known to impossible to pass an endotracheal tube through compressed airway forcibly. However, if ventilation proves difficult, an attempt should be made to pass the endotracheal tube down the least obstructed portion and some cases reporting successful ventilation through placing endotracheal tube passed further down beyond the obstruction even after neuromuscular blockade. We describe the anesthesia experience that placing the endotracheal tube passed beyond the obstruction using fiberoptic bronchoscope in child with total tracheal obstruction after induction of general anesthesia.
Keywords : Mediastinal mass; General anesthesia; Airway; Obstruction
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