[EngO8-4] Successful management fatal systemic air embolism of CT-guided lung biopsy: Case report
Introduction
Systemic air embolism (SAE) is a rare complication which may occur during CT guided lung biopsy. It happens very fast and often causes prompt collapse of the patient. Acute myocardial infarction and brain infarction caused by the SAE can lead to sudden death of patient. There’s no existing guideline or consensus on treating such condition. This case report aimed to share our experience of successfully rescuing a patient from life threatening systemic air embolism during CT guided biopsy of a lung nodule.
Case Presentation
A 70-year-old man who underwent CT guided lung biopsy for a nodule located at Right lower lobe, encountered a cough induced systemic air embolism during biopsy procedure. He progressed into cerebral and myocardial infarction in short time. He was intubated at scene, resuscitated initially and admitted to our ICU for further managmenet. Then, he received hyperbaric oxygen (HBO) treatment after stabilization. We arranged emergent hyperbaric Oxygen(HBO) therapy with set pressure of 3 ATA at around 24 hours after the event. Cardiac enzymes and function returned normal first and near full recovery of neurologic function was observed with the sequela of reduced fine motor control.
Conclusion
HBO therapy is essential to the treatment of SAE and can benefit in air absorption and symptom improvement. There was no consensus in treatment pressure, time and course, further study should be done to setup proper protocol for these patients.
Systemic air embolism (SAE) is a rare complication which may occur during CT guided lung biopsy. It happens very fast and often causes prompt collapse of the patient. Acute myocardial infarction and brain infarction caused by the SAE can lead to sudden death of patient. There’s no existing guideline or consensus on treating such condition. This case report aimed to share our experience of successfully rescuing a patient from life threatening systemic air embolism during CT guided biopsy of a lung nodule.
Case Presentation
A 70-year-old man who underwent CT guided lung biopsy for a nodule located at Right lower lobe, encountered a cough induced systemic air embolism during biopsy procedure. He progressed into cerebral and myocardial infarction in short time. He was intubated at scene, resuscitated initially and admitted to our ICU for further managmenet. Then, he received hyperbaric oxygen (HBO) treatment after stabilization. We arranged emergent hyperbaric Oxygen(HBO) therapy with set pressure of 3 ATA at around 24 hours after the event. Cardiac enzymes and function returned normal first and near full recovery of neurologic function was observed with the sequela of reduced fine motor control.
Conclusion
HBO therapy is essential to the treatment of SAE and can benefit in air absorption and symptom improvement. There was no consensus in treatment pressure, time and course, further study should be done to setup proper protocol for these patients.