title: Ventilation-induced massive lethal air embolism and subcutaneous emphysema in a patient with a lung cavern.
abstract: The simultaneous occurrence of subcutaneous emphysema and intravascular air due to an air embolism is a rare condition. Here, we report a patient with COPD who developed a severe episode of hemoptysis due to rupture of a previously undiagnosed lung cavern. Intubation and ventilation led to the development of both massive subcutaneous emphysema and a massive air embolism, resulting from aspiration of air through a torn pulmonary vessel in the cavern. The dramatic amount of intravenous air and subsequent conduction along the venous system to the right heart and pulmonary trunk caused major hemodynamic compromise and ultimately death. The degree of subcutaneous emphysema, especially the massive venous air embolism, was unprecedented.
authors.affiliation: Department of Critical Care Medicine.
authors.forename: Wim
authors.initials: W
authors.lastname: Verelst
authors.affiliation: Department of Critical Care Medicine.
authors.forename: Walter
authors.initials: W
authors.lastname: Verbrugghe
authors.affiliation: Department of Pathology.
authors.forename: Martin
authors.initials: M
authors.lastname: Lammens
authors.affiliation: Department of Radiology, Antwerp University Hospital, University of Antwerp, Edegem, Belgium.
authors.forename: Annemie
authors.initials: A
authors.lastname: Snoeckx
authors.affiliation: Department of Critical Care Medicine philippe.jorens@uza.be.
authors.forename: Philippe G
authors.initials: PG
authors.lastname: Jorens
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications*; D004618:Embolism, Air / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000150:complications*; D009336:Necrosis / Q000150:complications; D011175:Positive-Pressure Respiration / Q000009:adverse effects*; D013352:Subcutaneous Emphysema / Q000209:etiology*
keywords: air embolism; computed tomography scan; fatality; hemoptysis; lung cavern; subcutaneous emphysema