Systemic Air Embolism Following Induction of Artificial Pneumothorax Under Anaesthesia, With Successful Management

Abstract

Systemic air embolism occurred in a patient during general anaesthesia, with positive pressure ventilation, following induction of artificial pneumothorax to assist in the diagnosis of a mediastinal mass. A sudden change in vital signs together with neurological abnormalities suggested involvement of both coronary and cerebral arteries. A trace of blood was noticed in the syringe which the surgeon had used to create the artificial pneumothorax. The patient was treated with hyperbaric oxygen and recovered satisfactorily, despite a 10-h interval between the air embolus and the institution of definitive therapy.

Embolia aérea arterial durante anestesia para marcação percutânea de nódulo pulmonar: relato de caso

“…At expiration, venous pulmonary pressure higher than intra-bronchial pressure has allowed blood to migrate to airways and the tube. Arterial air embolism may occur in different circumstances, including heart surgery 9 , arterial injections 10 , central venous catheter positioning 11 , laparoscopy 12 and thoracic surgeries 13 , among others. It is critical for patients' prognosis that professionals dealing with procedures potentially risky for such complications be prepared for early diagnosis and prompt treatment.…”