title: [Lethal air embolism after spray of tissue adhesive-fibrinogen and factor XIII aerosol during laparoscopic partial nephrectomy].
abstract: We report a case of lethal air embolism just after spray of adhesive-fibrinogen and factor XIII aerosol during laparoscopic surgery. A 76-year-old man underwent laparoscopic partial nephrectomy for the left renal cancer. After partial nephrectomy, adhesive-fibrinogen and factor XIII aerosol were sprayed to a bleeding region of the kidney. The blood pressure and the end-tidal carbon dioxide concentration suddenly decreased, followed by cardiac arrest. Trans-esophageal echocardiography and computed tomography after cardiopulmonary resuscitation confirmed multiple air embolism. The use of a spray aerosol during laparoscopic surgery may be associated with the risk of lethal air embolism.
authors.affiliation: Department of Anesthesiology, Kansai Medical University, Hirakata 573-1191.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Umegaki
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Nishi
authors.forename: Kohei
authors.initials: K
authors.lastname: Murao
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Takahira
authors.forename: Koh
authors.initials: K
authors.lastname: Shingu
mesh_terms: D000336:Aerosols / Q000008:administration & dosage / Q000009:adverse effects*; D000368:Aged; D004618:Embolism, Air / Q000209:etiology*; D017809:Fatal Outcome; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D010535:Laparoscopy; D008297:Male; D009392:Nephrectomy
chemical_list: D000336:Aerosols; D015718:Fibrin Tissue Adhesive