Galvis Juan M, Nunley David R, Zheyi Teoh, Dinglasan Lu Anne V
Department of Pulmonary, Critical Care, and Sleep Disorders Medicine, University of Louisville School of Medicine, Louisville, KY, USA.
Internal Medicine and Pediatrics Department, University of Louisville School of Medicine, Louisville, KY, USA.
Respir Med Case Rep. 2017 Aug 12;22:206-208. doi: 10.1016/j.rmcr.2017.08.007. eCollection 2017.
Systemic arterial air embolism following a percutaneous transthoracic lung biopsy is a rare but known complication, with current literature reporting an incidence of 0.01-0.45%. A prompt diagnosis of arterial air embolism is important as complications resulting from migration of air to the systemic circulation with correspondent complications.
A 60-year-old female who presented for an elective percutaneous lung biopsy of an incidentally found pulmonary nodule. The procedure was performed, following the completion of the procedure the patient experiment syncopal symptoms and was diagnosed by CT scan with Left ventricular air embolism, subsequently transferred to Intensive care unit for medical attention, she was placed on right lateral decubitus Trendelenburg for 24 hours and administer 100% oxygen via a nonrebreather mask. Repeat chest CT the following day revealed complete resolution of her intracardiac free air.
Although systemic arterial air embolism remains a rare complication of percutaneous lung biopsies, recognition prevents potential mortality which can develop due to neurological and cardiac complications. Close vigilance in the intensive care unit is recommended and hyperbaric chamber when appropriate.
经皮经胸肺活检后发生系统性动脉空气栓塞是一种罕见但已知的并发症，目前文献报道的发生率为0.01%-0.45%。及时诊断动脉空气栓塞很重要，因为空气迁移至体循环会引发相应并发症。
一名60岁女性因偶然发现的肺结节接受择期经皮肺活检。手术完成后，患者出现晕厥症状，经CT扫描诊断为左心室空气栓塞，随后转至重症监护病房接受治疗，患者被置于右侧卧位头低脚高位24小时，并通过非重复呼吸面罩给予100%氧气。次日复查胸部CT显示其心内游离气体完全消散。
尽管系统性动脉空气栓塞仍然是经皮肺活检的罕见并发症，但认识到这一点可预防因神经和心脏并发症可能导致的潜在死亡。建议在重症监护病房密切观察，并在适当情况下使用高压氧舱。
