• Mathias Johansen, Indrani Lakheeram, and Natalie Buu.
• Department of Pediatric Anesthesia, Montreal Children's Hospital, 1001 Blvd Decarie, Montreal, QC, H4A 3J1, Canada. mathias.johansen@regionh.dk.
• Can J Anaesth. 2021 Sep 1; 68 (9): 1368-1372.

PurposeAnesthesia for endotracheal tumour mass resection in pediatric patients is a rare, complex, and high-risk procedure. The purpose of this case report is to emphasize the importance of multidisciplinary team collaboration and close communication during the perioperative management of shared airway surgery.Clinical FeaturesA six-year-old boy with no previous history of comorbidity and a 13-yr-old boy with a six-month history of upper respiratory tract infection, refractory asthma, chronic wheeze, and exercise-related dyspnea presented for acute endobronchial tumour mass resection. Decreased pulmonary function, religious beliefs (Jehovah's Witness), risk of intraluminal bleeding, and imminent complete airway collapse constitute areas of specific interest.ConclusionAnesthesia for endotracheal tumour mass resection in pediatric patients is a rare, complex, and high-risk procedure. Decreased pulmonary function and low respiratory reserves combined with the need for extensive surgical airway access warrants multidisciplinary team collaboration and close communication. Maintaining spontaneous respiration is paramount to reduce the risk of hypoxemia-induced adverse events and preoperative considerations should include the possible need for extracorporeal membrane oxygenation. Finally, the use of nasal high flow for shared airway surgery shows promising prospects warranting further investigation.© 2021. Canadian Anesthesiologists' Society.

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