Systemic Air Embolism Following Diagnostic Bronchoscopy

Abstract

A 51-year-old man was admitted to have a nodule evaluated using chest computed tomography (CT). Shortly after curetting and transbronchial biopsies via bronchoscopy, hypotension, bradycardia, unconsciousness, and left hemiplegia appeared and resolved within one hour. Head CT showed cerebral air embolism. The following day, lower left quadrant pain developed. Pneumatosis intestinalis on abdominal CT and elevation of creatine kinase and troponin T levels indicated air embolism in the mesenteric and coronary arteries. Some reports have documented cerebral air embolism alone after bronchoscopy; however, we should consider systemic air embolism, even when encountering a patient without specific symptoms related to any organ.

Cerebral Arterial Air Embolism after Diagnostic Flexible Fiberoptic Bronchoscopy: A Case Report and Review of the Literature

“…This is the ninth reported case in the literature of CAAE developing after diagnostic flexible fiberoptic bronchoscopy. The profiles of the reported patients, the examination procedures undertaken, the treatments, and the outcomes are shown in Table 1 [ 4 – 10 ]. TBLB or TBNA was performed prior to the development of CAAE in all the previously reported cases.…”

Cerebral arterial air embolism after endobronchial electrocautery: a case report and review of the literature

“…Targeted temperature management (TTM) may be helpful to prevent the deterioration of cerebral function in cases of CAAE [23]. Other organs should be examined by echocardiography, electrocardiogram or other examinations when encountering a patient with CAAE because systemic air embolisms should be considered [24]. This is the first reported case of CAAE after endobronchial electrocautery.…”

Cerebral Arterial Air Embolism After Endobronchial Electrocautery: A Case Report and Review of the Literature 

“…Targeted temperature management (TTM) may be helpful to prevent the deterioration of cerebral function in the cases of CAAE [23]. Other organs should be examined by echocardiography, electrocardiogram or other examinations when encountering a patient with CAAE, because systemic air embolisms should be considered [24].…”