
Chemoradiation therapy for oesophageal cancer with airway stenosis under mechanical ventilation with light sedation using dexmedetomidine alone
Author(s) -
Takashi Gondo,
Tomohiro Sonoo,
Hideki Hashimoto,
Kensuke Nakamura
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-234507
Subject(s) - dexmedetomidine , medicine , sedation , mechanical ventilation , anesthesia , airway , intubation , ventilation (architecture) , chemoradiotherapy , radiation therapy , airway management , surgery , mechanical engineering , engineering
For malignant tumours, treatment is rarely indicated in cases requiring mechanical ventilation management because such intensive care would engender a decrease in performance status. However, light sedation using dexmedetomidine might enable chemoradiation while accommodating activities of daily living. We experienced two cases of fatal tracheal invasion and airway stenosis of stage Ⅳ oesophageal cancer that were treated with chemoradiation or radiation under mechanical ventilation (one case was differential lung ventilation.) with dexmedetomidine alone and rehabilitation was performed under a ventilator. Early mobilisation by light sedation with dexmedetomidine can inhibit performance status decline attributable to mechanical ventilation. Bridging tracheal intubation with light sedation by dexmedetomidine for temporary chemoradiation therapy to reduce tumour volume might present a good alternative for patients with malignant tumour.