Clinic of Pulmonary Medicine, University Hospital Basel, Basel, Switzerland.
Respiration. 2010;80(6):569-72. doi: 10.1159/000321849. Epub 2010 Nov 16.
Flexible bronchoscopy is a widely used and safe procedure with a reported maximal mortality rate of 0.04% and a major-complications rate of 0.5%. There are, however, only few case descriptions for postinterventional cerebral air embolism and the frequency of this supposedly rare complication is unknown. The current study presents 2 patients with non-small cell lung cancer who suffered fatal cerebral air embolism following diagnostic bronchoscopy with transbronchial needle aspiration and transbronchial biopsy, resulting in a frequency of <0.02% for this severe complication in our institution. In addition to early supportive measures, 1 patient received hyperbaric oxygen therapy as further treatment. Prompt recognition of this complication is mandatory in order to implement appropriate supportive measures. High-flow oxygen should be administered and hyperbaric oxygen therapy may be considered, if available. If possible, positive pressure ventilation should be avoided.
纤维支气管镜检查是一种广泛应用且安全的操作，其报告的最大死亡率为 0.04%，主要并发症发生率为 0.5%。然而，对于介入后脑空气栓塞的病例描述很少，这种所谓的罕见并发症的发生率尚不清楚。本研究介绍了 2 例非小细胞肺癌患者，他们在诊断性支气管镜检查（经支气管针吸活检和经支气管活检）后发生致命性脑空气栓塞，在我们机构中，这种严重并发症的发生率<0.02%。除了早期支持措施外，1 例患者还接受高压氧治疗作为进一步治疗。为了实施适当的支持措施，必须及时识别这种并发症。应给予高流量氧气，如果有条件，可考虑高压氧治疗。如果可能，应避免正压通气。
