Children with mediastinal masses can have a variety of disparate clinical presentations, including chest pain, superior vena cava syndrome, Horner syndrome, pericardial effusion, and cardiac tamponade. Nonetheless, respiratory symptoms are present in 80% of children at presentation and are the most common presenting symptom. Management of respiratory failure due to mediastinal masses is challenging because intubation-with the accompanying sedation and paralysis-is likely to worsen the respiratory failure. For this reason, any new treatments for this condition are welcome. We report the case of an intubated 2-year-old girl with respiratory failure from a mediastinal mass who was successfully weaned from mechanical ventilatory support through the use of a 70%:30% helium-oxygen admixture (heliox). We then review mediastinal masses and the biophysical rationale for use of heliox in airway narrowing.
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http://dx.doi.org/10.1097/PEC.0b013e3181aba7de | DOI Listing |
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