The Use of Heliox and the Laryngeal Mask Airway in a Child with an Anterior Mediastinal Mass

Abstract

he patient with an anterior mediastinal mass and respiratory distress presents one of the most difficult problems in anesthetic management. When the mass is a malignancy, patients require an accurate tissue diagnosis to determine the optimal therapy, which may limit the preoperative administration of chemotherapy, steroids, or radiotherapy. Nonmalignant masses, such as teratomas and cystic hygromas, are not amenable to such therapy. Numerous reports in the anesthesia literature have described both the pitfalls and the optimal management of these patients. We report the use of heliox, a gas containing 20 % oxygen and 80 % helium, and the laryngeal mask airway (LMA) for the administration of anesthesia to a 3-yr-old boy with asthma and a large anterior mediastina