Left ventricle and systemic air embolism after percutaneous lung biopsy

Abstract

BackgroundSystemic arterial air embolism following a percutaneous transthoracic lung biopsy is a rare but known complication, with current literature reporting an incidence of 0.01–0.45%. A prompt diagnosis of arterial air embolism is important as complications resulting from migration of air to the systemic circulation with correspondent complications.Case reportA 60-year-old female who presented for an elective percutaneous lung biopsy of an incidentally found pulmonary nodule. The procedure was performed, following the completion of the procedure the patient experiment syncopal symptoms and was diagnosed by CT scan with Left ventricular air embolism, subsequently transferred to Intensive care unit for medical attention, she was placed on right lateral decubitus Trendelenburg for 24 hours and administer 100% oxygen via a nonrebreather mask. Repeat chest CT the following day revealed complete resolution of her intracardiac free air.ConclusionAlthough systemic arterial air embolism remains a rare complication of percutaneous lung biopsies, recognition prevents potential mortality which can develop due to neurological and cardiac complications. Close vigilance in the intensive care unit is recommended and hyperbaric chamber when appropriate.

Risk factors for air embolism following computed tomography-guided percutaneous transthoracic needle biopsy: a systematic review and meta-analysis

“…Figure 1 presents this study’s PRISMA flow diagram, which summarizes the screening process and the reasons for exclusion. A total of 104 studies 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , …”

Air embolism as a rare complication of lung biopsy: A case report

“…Several cases described air embolism after lung biopsy [5 , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] ]. However, most of these studies included solid lung lesions with no air component.…”

Uncommon Occurrences of Air Embolism: Description of Cases and Review of the Literature

“…In the described cases, the prevention of GE clearly was not feasible in case number 1 but it could have been avoided using CO 2 to inflate the duodenum in the second case. In patient number 3, this issue is difficult to establish, as other cases have been described in patients undergoing lung or pleural biopsies under thoracoscopy [ 36 , 37 ]. In these circumstances, a high index of suspicion is warranted to detect as soon as possible neurologic and/or cardiovascular abnormalities possibly caused by a GE and to shorten the treatment-free interval.…”