•Adults: NaHCO3. There are few data regarding children

•Life-threatening hypercalcemia: hemodialysis in collaboration with nephrology department

18.5Airway Compression

18.5.1 General

•One of the few oncological emergencies which needs immediate diagnosis and involvement of intensive care, anesthetic, and oncology departments

•Differential diagnosis of malignancies: non-Hodgkin lymphoma, neuroblastoma, Hodgkin lymphoma, rarely germ cell tumors, Ewing sarcoma, rhabdomyosarcoma, thymoma, and others

18.5.2 Diagnosis

•Symptoms: cough, hoarseness, stridor, dyspnea, orthopnea, chest pain, headache, syncope, and others

•Laboratory analysis: blood gas analysis, complete blood count with differential count

•Sodium, potassium, calcium, magnesium, urea, creatinine, phosphorus, uric acid, lactate dehydrogenase (LDH)

•Radiology: chest X-ray: mediastinum, tracheal shift, pleural effusion

•CT scan: compression of trachea and bronchi; space-occupying process; location of compressing tumor (anterior or posterior mediastinum); infiltration of lungs

•Compression of superior caval vein

•Echocardiography

•Diagnostic algorithm in collaboration with oncologist (e.g., biopsy of lymph nodes, bone marrow aspiration, thoracocentesis, pleurocentesis)

18.5.3 Treatment

•Request an anesthesist and/or intensive care immediately

•Intravenous line

•Immediate initiation of specific treatment (e.g., cytotoxic agents, in the case of non-Hodgkin lymphoma or leukemia)

•Possibly dexamethasone, after oncology consultation (initially 0.2–0.4 mg/kg, then 0.3 mg/kg per day in three or four doses/day)

•Consider radiotherapy