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Life-threatening presentation of mediastinal neoplasms: report on 7 consecutive pediatric patients
Marco Piastra1, Antonio Ruggiero, Elena Caresta
1Pediatric Intensive Care Unit, Catholic University Medical School, 00168 Rome, Italy. xoct01@yahoo.it
Insights
Pediatric respiratory failure from anterior mediastinal tumors is challenging but manageable. Urgent pediatric intensive care (PICU) ensures recovery and allows for effective cancer treatment.
Area of Science:
- Pediatric Oncology
- Critical Care Medicine
- Thoracic Surgery
Background:
- Anterior mediastinal malignancies in children can cause life-threatening respiratory failure.
- Superior mediastinal syndrome presents a significant clinical challenge, necessitating urgent intervention.
Observation:
- Seven pediatric patients (0.8-14 years) with critical mediastinal neoplasms were admitted to a pediatric intensive care unit.
- All patients experienced respiratory compromise requiring ventilatory and/or cardiovascular support.
- Two patients required renal replacement therapy.
Findings:
- Despite critical presentation, all seven children were discharged from the Pediatric Intensive Care Unit.
- Prompt intensive care management was crucial for patient stabilization and recovery.
Implications:
- Critical presentation of mediastinal neoplasms in children does not preclude a favorable outcome.
- An intensive care approach is vital for successful patient recovery and administration of antineoplastic therapies.
Background:
Cases of respiratory failure at presentation in children with anterior mediastinal malignancies can be very challenging for clinicians. Seven consecutive children presenting with superior mediastinal syndrome are reported needing urgent critical care approach.
Patients And Methods:
Seven children (age range from 0.8 to 14 years; mean, 4.5 years) suffered from critical mediastinal neoplasms. Clinical presentation, laboratory findings, treatment, and outcome are discussed.
Setting:
a tertiary-care 6-bed medical and surgical pediatric intensive care in a university hospital. Interventions included emergency management, resuscitation and intensive care admission, and diagnostic and therapeutic procedures.
Results:
All cases showed a respiratory compromise and underwent ventilatory and/or cardiovascular support. Two patients needed renal replacement therapy. Pediatric Intensive Care Unit discharge was achieved in all patients.
Conclusions:
Critical or extreme presentation of mediastinal neoplasms does not preclude a good clinical outcome: an intensive care approach is essential to allow patient recovery and effective antineoplastic therapy administration.