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Article: Recommendations on the Management of Interhospital Transport of Pediatric Patients With Mediastinal Mass

TitleRecommendations on the Management of Interhospital Transport of Pediatric Patients With Mediastinal Mass
Authors
Keywordsmediastinal mass
interhospital transport
airway obstruction
superior vena cava obstruction
anterior mediastinal mass
Issue Date2021
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.pec-online.com
Citation
Pediatric Emergency Care, 2021, Epub 2021-08-19 How to Cite?
AbstractPurpose: Children with mediastinal masses often present with insidious symptoms to nonspecialist centers and require interhospital transport to oncology centers for definitive care. We evaluated clinical characteristics and patient outcomes and proposed a management protocol. Materials and methods: This is a retrospective review of all children with mediastinal mass at the pediatric intensive care unit of the Hong Kong Children's Hospital between April 2019 and March 2020. Results: Ten children with a median age of 14.5 years (interquartile range, 9.3-17.0 years) were included. Leukemia and lymphoma accounted for the majority of cases (n = 6, 60%). Nearly all patients (n = 9, 90%) required interhospital transport before definitive treatment could be instituted. There were no deaths, but 2 patients were transported with significant respiratory compromise. Among patients requiring more than 1 interhospital transport, there was a higher incidence of shortness of breath (100% vs 40%; odds ratio, 33; P = 0.048) and orthopnea (80% vs 0%; odds ratio, 33; P = 0.048), whereas none had a neck mass (0% vs 80%; odds ratio, 0.03; P = 0.048). Conclusions: Children with mediastinal mass are at risk of life-threatening cardiorespiratory compromise. Pretransport assessment, planning, and stabilization along with clear management plans for deterioration during transport are crucial especially for patients who are symptomatic at time of presentation, to reduce risks associated with delays in arriving at the specialist point of care for definitive treatment.
Persistent Identifierhttp://hdl.handle.net/10722/306726
ISSN
2023 Impact Factor: 1.2
2023 SCImago Journal Rankings: 0.489
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLeung, KKY-
dc.contributor.authorKu, SW-
dc.contributor.authorHon, KL-
dc.contributor.authorChigaru, L-
dc.contributor.authorChiang, AKS-
dc.contributor.authorKan, EYL-
dc.contributor.authorOberender, F-
dc.date.accessioned2021-10-22T07:38:43Z-
dc.date.available2021-10-22T07:38:43Z-
dc.date.issued2021-
dc.identifier.citationPediatric Emergency Care, 2021, Epub 2021-08-19-
dc.identifier.issn0749-5161-
dc.identifier.urihttp://hdl.handle.net/10722/306726-
dc.description.abstractPurpose: Children with mediastinal masses often present with insidious symptoms to nonspecialist centers and require interhospital transport to oncology centers for definitive care. We evaluated clinical characteristics and patient outcomes and proposed a management protocol. Materials and methods: This is a retrospective review of all children with mediastinal mass at the pediatric intensive care unit of the Hong Kong Children's Hospital between April 2019 and March 2020. Results: Ten children with a median age of 14.5 years (interquartile range, 9.3-17.0 years) were included. Leukemia and lymphoma accounted for the majority of cases (n = 6, 60%). Nearly all patients (n = 9, 90%) required interhospital transport before definitive treatment could be instituted. There were no deaths, but 2 patients were transported with significant respiratory compromise. Among patients requiring more than 1 interhospital transport, there was a higher incidence of shortness of breath (100% vs 40%; odds ratio, 33; P = 0.048) and orthopnea (80% vs 0%; odds ratio, 33; P = 0.048), whereas none had a neck mass (0% vs 80%; odds ratio, 0.03; P = 0.048). Conclusions: Children with mediastinal mass are at risk of life-threatening cardiorespiratory compromise. Pretransport assessment, planning, and stabilization along with clear management plans for deterioration during transport are crucial especially for patients who are symptomatic at time of presentation, to reduce risks associated with delays in arriving at the specialist point of care for definitive treatment.-
dc.languageeng-
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.pec-online.com-
dc.relation.ispartofPediatric Emergency Care-
dc.rightsThis is a non-final version of an article published in final form in (provide complete journal citation)-
dc.subjectmediastinal mass-
dc.subjectinterhospital transport-
dc.subjectairway obstruction-
dc.subjectsuperior vena cava obstruction-
dc.subjectanterior mediastinal mass-
dc.titleRecommendations on the Management of Interhospital Transport of Pediatric Patients With Mediastinal Mass-
dc.typeArticle-
dc.identifier.emailLeung, KKY: kkyleung@hku.hk-
dc.identifier.emailChiang, AKS: chiangak@hku.hk-
dc.identifier.authorityChiang, AKS=rp00403-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/PEC.0000000000002517-
dc.identifier.pmid34417789-
dc.identifier.hkuros328940-
dc.identifier.volumeEpub 2021-08-19-
dc.identifier.isiWOS:000761960200028-
dc.publisher.placeUnited States-

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