Air embolism during CT-guided transthoracic needle biopsy. 2011

Wolfgang Lederer, and Christoph J Schlimp, and Bernhard Glodny, and Franz J Wiedermann
Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria.

Air embolism (AE) is a potential complication during transthoracic needle biopsy (TNB). The authors report on venous and systemic AE during CT-guided TNB under general anaesthesia. During the intervention, the radiologist observed accumulation of air bubbles in the left heart chambers, in the right subclavian vein, the superior vena cava and the right atrium. This was presumably due to pressure infusion of contrast medium (CM) air entrained via a stop-cock improperly fixed to the venous cannula or via the injection valve of the cannula by Venturi forces. Prevention of AE related to CM infusion is a subject for institutional risk management. Stop-cocks and injection valves should not be used in intravenous lines supplied by pressure infusions. Adverse outcome may be avoided by placing the patient head down, increasing FiO(2) to 1.0, administering antithrombotic therapy and immobilizing the patient on the intervention table until CT has proved complete remission of AE.

UI MeSH Term Description Entries
D008297 Male Males
D004618 Embolism, Air Blocking of a blood vessel by air bubbles that enter the circulatory system, usually after TRAUMA; surgical procedures, or changes in atmospheric pressure. Air Embolism,Embolism, Gas,Air Embolisms,Embolisms, Air,Embolisms, Gas,Gas Embolism,Gas Embolisms
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001707 Biopsy, Needle Removal and examination of tissue obtained through a transdermal needle inserted into the specific region, organ, or tissue being analyzed. Aspiration Biopsy,Puncture Biopsy,Aspiration Biopsies,Biopsies, Aspiration,Biopsies, Needle,Biopsies, Puncture,Biopsy, Aspiration,Biopsy, Puncture,Needle Biopsies,Needle Biopsy,Puncture Biopsies
D014057 Tomography, X-Ray Computed Tomography using x-ray transmission and a computer algorithm to reconstruct the image. CAT Scan, X-Ray,CT Scan, X-Ray,Cine-CT,Computerized Tomography, X-Ray,Electron Beam Computed Tomography,Tomodensitometry,Tomography, Transmission Computed,X-Ray Tomography, Computed,CAT Scan, X Ray,CT X Ray,Computed Tomography, X-Ray,Computed X Ray Tomography,Computerized Tomography, X Ray,Electron Beam Tomography,Tomography, X Ray Computed,Tomography, X-Ray Computer Assisted,Tomography, X-Ray Computerized,Tomography, X-Ray Computerized Axial,Tomography, Xray Computed,X Ray Computerized Tomography,X Ray Tomography, Computed,X-Ray Computer Assisted Tomography,X-Ray Computerized Axial Tomography,Beam Tomography, Electron,CAT Scans, X-Ray,CT Scan, X Ray,CT Scans, X-Ray,CT X Rays,Cine CT,Computed Tomography, Transmission,Computed Tomography, X Ray,Computed Tomography, Xray,Computed X-Ray Tomography,Scan, X-Ray CAT,Scan, X-Ray CT,Scans, X-Ray CAT,Scans, X-Ray CT,Tomographies, Computed X-Ray,Tomography, Computed X-Ray,Tomography, Electron Beam,Tomography, X Ray Computer Assisted,Tomography, X Ray Computerized,Tomography, X Ray Computerized Axial,Transmission Computed Tomography,X Ray Computer Assisted Tomography,X Ray Computerized Axial Tomography,X Ray, CT,X Rays, CT,X-Ray CAT Scan,X-Ray CAT Scans,X-Ray CT Scan,X-Ray CT Scans,X-Ray Computed Tomography,X-Ray Computerized Tomography,Xray Computed Tomography
D061705 Image-Guided Biopsy Conducting a biopsy procedure with the aid of a MEDICAL IMAGING modality. Imaging Guided Biopsy,Biopsies, Image-Guided,Biopsies, Imaging Guided,Biopsy, Image-Guided,Biopsy, Imaging Guided,Guided Biopsies, Imaging,Guided Biopsy, Imaging,Image Guided Biopsy,Image-Guided Biopsies,Imaging Guided Biopsies

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