Cerebral air embolism complicating bilevel positive airway pressure therapy.
A 13 yr old male with acute lymphoblastic leukaemia who received bilevel positive airway pressure ventilation via a face mask for post-transplant pneumonitis developed subcutaneous emphysema, radiographic evidence of pulmonary interstitial emphysema, pneumomediastinum and 6 h later, right hemiparesis and focal livedo reticularis. This case illustrates that severe barotrauma may complicate noninvasive bilevel positive airway pressure ventilation.
Dept of Medicine, Veterans General Hospital, Taipei, Taiwan, ROC.
S C
SC
Hung
H C
HC
Hsu
S C
SC
Chang
D000293:Adolescent; D001469:Barotrauma / Q000209:etiology; D004618:Embolism, Air / Q000209:etiology*; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000209:etiology*; D055370:Lung Injury; D008297:Male; D008478:Mediastinal Emphysema / Q000209:etiology; D011175:Positive-Pressure Respiration / Q000295:instrumentation*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D011656:Pulmonary Emphysema / Q000209:etiology