title: Cerebral air embolism following transbronchial lung biopsy during flexible bronchoscopy.
abstract: During a diagnostic flexible bronchoscopy an 84 year old patient suffered a sudden reduction in conscious level following a transbronchial lung biopsy. A subsequent computed tomography brain scan confirmed cerebral air emboli. The patient survived following a period of supportive treatment in the critical care unit. Transbronchial lung biopsy may cause disruption of vessels walls within the lung parenchyma. Increased airway pressure, caused by the patient exhaling against a bronchoscope wedged within a segmental bronchi, may subsequently force air bubbles through the vessel wall defects. This may explain the occurrence of air emboli. This is a rare report of air embolism complicating transbronchial lung biopsy and all bronchoscopists should aware of this potentially fatal complication.
authors.affiliation: North West Lung Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe M23 9LT, UK ; The Institute of Inflammation and Repair, The University of Manchester, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Evison
authors.affiliation: North West Lung Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe M23 9LT, UK ; The Institute of Inflammation and Repair, The University of Manchester, UK.
authors.forename: Philip A J
authors.initials: PA
authors.lastname: Crosbie
authors.affiliation: North West Lung Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe M23 9LT, UK.
authors.forename: Rowland
authors.initials: R
authors.lastname: Bright-Thomas
authors.affiliation: North West Lung Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe M23 9LT, UK.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Alaloul
authors.affiliation: North West Lung Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe M23 9LT, UK ; The Institute of Inflammation and Repair, The University of Manchester, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Booton
keywords: Air embolism; Bronchoscopy; Transbronchial lung biopsy