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Updated: Jan 22, 2026

A Structured Approach to Extubation in Mechanically Ventilated Rats
Published on: July 18, 2025
Difficulties in tracheal extubation due to phrenic nerve injury during massive mediastinal tumor resection: A case
Kui-Rong Wang1, Fan-Fan Liu, Yan-Feng Zhou
1Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, P. R. China.
Rationale:
Massive mediastinal tumors present a major challenge for surgery and anesthesia management due to possible perioperative circulation and respiratory dysfunction.
Patient Concerns:
A 36-year-old female underwent difficulty with tracheal extubation and required mechanical ventilation for 3 months after resection of a massive mediastinal tumor.
Diagnoses:
Postoperative B-ultrasound examination of diaphragmatic motor weakness and electrophysiological examination indicated respiratory failure due to phrenic nerve injury.
Interventions:
The patient failed tracheal extubation several times after the operation and finally a tracheotomy was performed. Mechanical ventilation, anti-infective treatment, and systemic supportive treatment were provided.
Outcomes:
The patient recovered well after tracheotomy and approximately 3 months of ventilation support.
Lessons:
Weaning difficulty caused by phrenic nerve injury seriously affected patient postoperative rehabilitation. To reduce the occurrence of similar problems, intraoperative phrenic nerve electrophysiological monitoring should be conducted.
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