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Femorofemoral Cardiopulmonary Bypass in the Management of Severe Airway Obstruction by Thyroid Cancer: A Case Report / 대한마취과학회지
Korean Journal of Anesthesiology ; : 236-240, 2004.
Article in Korean | WPRIM | ID: wpr-126922
ABSTRACT
Severe upper airway obstruction due to thyroid cancer is often related severe hypoxia and hypercarbia during anesthesia induction. Attempts to insert an endotracheal tube or a bronchoscope may cause complete immediate airway obstruction. We anesthetized two patients. One had a large mediastinal thyroid mass which compressed trachea and caused near complete obstruction, and the other patient had a large papillary thyroid cancer, which had invaded larynx and compressed the upper trachea. Patients were sedated with fentanyl 150microgram i.v. and a target controlled infusion (TCI, 1.8microgram/ml) of propofol. A femorofemoral cardiopulmonary bypass was performed under local anesthesia. After bypass, the propofol TCI concentration was increased to 3.5microgram/ml, and fentanyl 500microgram and vecuronium 6 mg were injected. Ventilation was performed using a laryngeal mask in one patient, and a laryngeal tube in the other. After removing the tumor mass, the airway was secured, and the cardiopulmonary bypass discontinued. All patients recovered uneventfully and were discharged. We discuss the management of severe upper airway obstruction and the usefulness of cardiopulmonary bypass.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Thyroid Gland / Trachea / Ventilation / Vecuronium Bromide / Thyroid Neoplasms / Cardiopulmonary Bypass / Propofol / Fentanyl / Laryngeal Masks / Bronchoscopes Type of study: Diagnostic study Limits: Humans Language: Korean Journal: Korean Journal of Anesthesiology Year: 2004 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Thyroid Gland / Trachea / Ventilation / Vecuronium Bromide / Thyroid Neoplasms / Cardiopulmonary Bypass / Propofol / Fentanyl / Laryngeal Masks / Bronchoscopes Type of study: Diagnostic study Limits: Humans Language: Korean Journal: Korean Journal of Anesthesiology Year: 2004 Type: Article