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Case report
Cerebral Arterial Air Embolism After Endobronchial Electrocautery: A Case Report and Review of the Literature
Lihua Wang
Yunfu People's Hospital Yunfu City, Huanshi Dong Lu No.120, Yuncheng District, 527300, China
Corresponding Author
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Background: Endobronchial electrocautery is a common and safe therapeutic endoscopic treatment for malignant airway obstruction. Cerebral arterial air embolism (CAAE) is a rare but potentially fatal complication of endobronchial electrocautery.
Case presentation: We present the first case of cerebral arterial air embolism after endobronchial electrocautery. A 56-year-old male with a pulmonary tumor in the right upper lobe received a repeated endobronchial electrocautery. During the procedure, he experienced unresponsive, hypoxemic, bradycardic and developed tetraplegia. The brain computer tomography showed several cerebral arterial air emboli with low-density spots in the right frontal lobe. He received hyperbaric oxygen therapy with almost full recovery except resident left-sided weakness.
Conclusions: General physicians should realize that CAAE can be a possible complication of endobronchial electrocautery. Some measures could be used to prevent this devastating complication: avoiding positive pressure, lowering ventilatory pressures if possible, avoiding advancing the bronchoscope to occlude the bronchus, and using the non-contact technique etc.
Keywords
air embolism, bronchoscopy, endobronchial electrocautery, hyperbaric oxygen therapy
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This is a preprint. It has not completed peer review.
Case report
Cerebral Arterial Air Embolism After Endobronchial Electrocautery: A Case Report and Review of the Literature
Lihua Wang
Yunfu People's Hospital Yunfu City, Huanshi Dong Lu No.120, Yuncheng District, 527300, China
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 17 Sep, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Oncology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Endobronchial electrocautery is a common and safe therapeutic endoscopic treatment for malignant airway obstruction. Cerebral arterial air embolism (CAAE) is a rare but potentially fatal complication of endobronchial electrocautery.
Case presentation: We present the first case of cerebral arterial air embolism after endobronchial electrocautery. A 56-year-old male with a pulmonary tumor in the right upper lobe received a repeated endobronchial electrocautery. During the procedure, he experienced unresponsive, hypoxemic, bradycardic and developed tetraplegia. The brain computer tomography showed several cerebral arterial air emboli with low-density spots in the right frontal lobe. He received hyperbaric oxygen therapy with almost full recovery except resident left-sided weakness.
Conclusions: General physicians should realize that CAAE can be a possible complication of endobronchial electrocautery. Some measures could be used to prevent this devastating complication: avoiding positive pressure, lowering ventilatory pressures if possible, avoiding advancing the bronchoscope to occlude the bronchus, and using the non-contact technique etc.
Figure 1
Figure 2
Figure 3