Patient (condition)
 
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Assessing patient in the supine position will help exacerbate subclinical symptoms of cardio-respiratory compromise caused by the mass.

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Examine all imaging available including CT Chest and CXR to determine relationship of mass to intrathoracic structures (trachea, bronchi, great vessels, heart chambers) to determine risk of cardiorespiratory compromise on induction

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Lung function tests may help reveal any obstructive respiratory patterns

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See also Mediastinoscopy

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IV lines in the lower limbs will more reliably deliver volume to the heart than lines in the upper limb. This is especially the case with large mediastinal masses obstructing the superior vena cava or subclavian veins, and and in the event of rupture of the major vessels during surgical dissection.

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If respiratory collapse occurs on induction, lateral/prone positioning may relieve obstruction

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Patients with very large mediastinal masses are at risk of pulmonary or cardiovascular collapse during anaesthesia. Bypass may be required if compromisation of the airway or major vessels occurs.

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