Management of the patient with a large anterior mediastinal mass: recurring myths

被引:101
作者
Slinger, Peter [1 ]
Karsli, Cengiz [2 ]
机构
[1] Toronto Gen Hosp, 200 Elizabeth St, Toronto, ON M5G 2C4, Canada
[2] Hosp Sick Children, Toronto, ON M5G 1X8, Canada
关键词
D O I
10.1097/ACO.0b013e328011390b
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Purpose of review This editorial review summarizes the current anesthetic management of patients with anterior mediastinal masses. Recent findings With increased appreciation of the correct intraoperative management of these cases severe intraoperative respiratory or cardiovascular collapse is less likely to occur during general anesthesia. Maintenance of spontaneous ventilation is the anesthetic goal whenever possible. Major life-threatening complications now occur more frequently postoperatively. Summary General anesthesia is not safe in patients with severe positional symptoms from an anterior mediastinal mass. With modern imaging techniques, general anesthesia is rarely needed for diagnostic procedures in these patients. Preoperative flow-volume loops are not useful in the management of these patients and the concept of cardiopulmonary bypass on 'standby' is not appropriate during induction of anesthesia.
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页码:1 / 3
页数:3
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