Almeida Francisco Aécio, Desouza Bryan X, Meyer Thomas, Gregory Susan, Greenspon Lee
Division of Critical Care, Pulmonary, Allergic, and Immunologic Diseases, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Chest. 2006 Aug;130(2):575-7. doi: 10.1378/chest.130.2.575.
Although it is estimated that > 1 billion passengers travel by air worldwide each year, the incidence of in-flight emergencies is low. However, due to nonstandardized reporting requirements for in-flight medical emergencies, the true incidence of pulmonary barotrauma in airplane passengers is unknown. We describe the case of a passenger with an asymptomatic intrapulmonary cyst in whom a severe case of cerebral gas embolism developed during an aircraft flight. The decrease in ambient pressure during the aircraft climb resulted in expansion of the cyst volume based on Boyle's law (pressure x volume = constant). Due to the cyst expansion, we believe tears in the wall led to the leakage of air into the surrounding vessels followed by brain gas emboli. Adult patients with intrapulmonary cysts should be strongly considered for cyst resection or should at least be advised to abstain from activities leading to considerable changes in ambient pressure.
尽管据估计全球每年有超过10亿乘客乘坐飞机出行,但飞行中紧急情况的发生率较低。然而,由于飞行中医疗紧急情况的报告要求不规范,飞机乘客中肺气压伤的真实发生率尚不清楚。我们描述了一名患有无症状肺内囊肿的乘客的病例,该乘客在飞机飞行过程中发生了严重的脑气体栓塞。飞机爬升过程中环境压力的降低导致囊肿体积根据玻意耳定律(压力×体积 = 常数)膨胀。由于囊肿扩张,我们认为囊肿壁的撕裂导致空气漏入周围血管,随后形成脑气体栓塞。对于患有肺内囊肿的成年患者,应强烈考虑进行囊肿切除,或者至少应建议其避免从事会导致环境压力发生显著变化的活动。