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Published on: June 2, 2022

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Risk factors for anesthetic-related complications in pediatric patients with a newly diagnosed mediastinal mass

Neal Campbell1, Alex Tsai2, Brenton Reading3

  • 1Department of Anesthesiology, Children's Mercy Hospital, Kansas City, MO, USA.

Paediatric Anaesthesia
|September 5, 2021
PubMed

Insights

Anesthetic complications in pediatric patients with mediastinal masses are linked to airway compression and intubation. Preprocedure orthopnea did not predict complications, which occurred similarly across mass sizes and locations.

Area of Science:

  • Anesthesiology
  • Pediatric Critical Care
  • Thoracic Surgery

Background:

  • Pediatric patients with mediastinal masses face significant anesthetic risks.
  • Existing reviews often focus narrowly on anterior masses or oncologic conditions.

Purpose of the Study:

  • To identify risk factors for anesthetic complications in pediatric patients with any mediastinal mass.
  • To broaden understanding beyond specific mass types or locations.

Main Methods:

  • Retrospective review of 86 pediatric patients diagnosed with mediastinal masses from 2008-2019.
  • Analysis of presenting symptoms, imaging, anesthetic type, and complications (hypoxia, hypotension, loss of end-tidal CO2).

Main Results:

  • Seven percent of patients experienced complications.
  • Tracheal compression (15%) and mainstem bronchus compression (14%) were associated with higher complication rates.
  • Intubation was linked to a higher incidence of complications (13%).

Conclusions:

  • Airway compression and endotracheal intubation are key risk factors for anesthetic complications.
  • Absence of preprocedure orthopnea does not guarantee an uncomplicated anesthetic.
  • Complication frequency was consistent across various mediastinal mass locations and sizes.
Abstract

Keywords:
adverse eventscomplicationsgeneral anesthesiaoncologyoutcomesquality improvement

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