BACKGROUND: Anterior mediastinal tumors in pediatric patients may cause severe cardiorespiratory compromise and sudden collapse, especially when anesthesia or analgesic is required. METHOD: We report a 15-year-old boy with a huge anterior mediastinal tumor that caused complete obliteration of right pulmonary artery and left bronchus, that is, complete ventilation-perfusion mismatch. Cardiopulmonary collapse happened after meperidine injection, and extracorporeal membrane oxygenation (ECMO) was instituted. RESULTS: We then put bronchial stents to restore airway patency and proceeded chemotherapy under ECMO support. Extracorporeal membrane oxygenation was removed 40 hours later. However, the patient died of neutropenic sepsis 9 days after admission. CONCLUSIONS: We emphasized the devastating consequences of anterior mediastinal tumor compression on the pulmonary artery and the contralateral-side bronchus and the use of ECMO as a rescue.
BACKGROUND: Anterior mediastinal tumors in pediatric patients may cause severe cardiorespiratory compromise and sudden collapse, especially when anesthesia or analgesic is required. METHOD: We report a 15-year-old boy with a huge anterior mediastinal tumor that caused complete obliteration of right pulmonary artery and left bronchus, that is, complete ventilation-perfusion mismatch. Cardiopulmonary collapse happened after meperidine injection, and extracorporeal membrane oxygenation (ECMO) was instituted. RESULTS: We then put bronchial stents to restore airway patency and proceeded chemotherapy under ECMO support. Extracorporeal membrane oxygenation was removed 40 hours later. However, the patient died of neutropenic sepsis 9 days after admission. CONCLUSIONS: We emphasized the devastating consequences of anterior mediastinal tumor compression on the pulmonary artery and the contralateral-side bronchus and the use of ECMO as a rescue.