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J Thorac Cardiovasc Surg 2007;134:262-263
© 2007 The American Association for Thoracic Surgery

Brief Communication

Cerebral air embolism after noninvasive ventilation postpulmonary wedge resection

Department of Cardiothoracic Surgery, London Chest Hospital, Bonner Road, London, United Kingdom.

Received for publication November 24, 2006; accepted for publication December 12, 2006.

^_* Address for reprints: Mr W.I. Awad, MRCS, Department of Cardiothoracic Surgery, London Chest Hospital, Bonner Road, London, United Kingdom E29JX (E-mail: w.awad@barts or london.nhs.org).

The first 20% of the full text of this article appears below.

Systemic air embolism (SAE) has been reported after pulmonary trauma,¹ surgery,² and interventional procedures, often in association with positive pressure ventilation. Cerebral air embolism (CAE), a subset of SAE, is a rare complication of thoracic procedures^3,4 that causes cerebral ischemia and inflammation. CAE has been reported in association with noninvasive positive pressure ventilation (NIPPV),⁵ but never postoperatively. We report a case of CAE after initiation of NIPPV in an emphysematous patient postpulmonary wedge resection.

Clinical Summary

A 68-year-old man with a smoking habit and severe emphysema presented for surgical excision biopsy of a 2 x 1.5-cm irregular right lower lobe pulmonary nodule. On a positron emission tomographic scan, the lesion was fluorodeoxyglucose avid. Through a left thoracotomy, the lesion was excised with 4 firings of the EZ45 stapling device (Ethicon Endo Surgery, Cincinnati, Ohio). The patient was extubated at the end of the procedure.

Type 2 respiratory failure developed after 2 hours . . . [Full Text of this Article]

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