/ Suzanne Cronly
1. Outline of Lecture:
Title: Mediastinal Masses and their Anaesthetic Implications in children
In this lecture, the clinical concerns and the safest anaesthetic approach for children presenting with Mediastinal masses are both examined in detail.
The lecture considers common and uncommon causes of anterior mediastinal masses and their implications for anaesthesia focussing on the effects on the respiratory and cardiovascular systems.
Various risk factors such as age, dyspnoea, orthopnoea and severity of tracheal compression on CT scan and their predictive values for either airway or cardiovascular collapse are explored and discussed. The talk also seeks to examine the pathophysiological processes and their possible consequences resulting from the loss of motor tone and the potential change from negative to positive pressure ventilation occurring during the induction of anaesthesia.
Using some clinical examples the concept of anaesthesia risk stratification to; safe, unsafe and uncertain patient risk categories is discussed. The lecture explores different anaesthetic options and how to carefully proceed in the uncertain patient without ‘burning your bridges.
Other issues, such as when to have Extra Corporeal Membrane Oxygenation (ECMO) on standby, when to have the cardiovascular surgeon readily available or when to have the rigid bronchoscope and ENT surgeon in the room prior to the Induction of anaesthesia are also discussed.
Suzanne Cronly has been a Consultant in Anaesthesia and Critical Care Medicine in Our Lady’s Children’s Hospital (OLCHC) since 2015. She obtained her Certificate of Specialist training from the College of Anaesthetists of Ireland in 2012 and went on to complete a two year Paediatric Critical Care Medicine Fellowship in Boston Children’s Hospital and a one year Paediatric Anaesthesia Fellowship in Great Ormond Street Hospital.
She has been one of the College tutors in OLCHC since 2016.