Wang KR, Liu FF, Zhou YF. Difficulties in tracheal extubation due to phrenic nerve injury during massive mediastinal tumor resection: A case report.
Medicine (Baltimore) 2019;
98:e16252. [PMID:
31261591 PMCID:
PMC6617445 DOI:
10.1097/md.0000000000016252]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
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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