Abstract
BackgroundEndobronchial electrocautery is a common and safe therapeutic endoscopic treatment for malignant airway obstruction. Cerebral arterial air embolism (CAAE) is a rare but potentially fatal complication of endobronchial electrocautery.Case presentationWe present the first case of cerebral arterial air embolism after endobronchial electrocautery. A 56-year-old male with a pulmonary tumour in the right upper lobe received repeated endobronchial electrocautery. During the procedure, he experienced unresponsiveness, hypoxemia and bradycardia, and he developed tetraplegia. Brain computed tomography showed several cerebral arterial air emboli with low-density spots in the right frontal lobe. He received hyperbaric oxygen therapy with almost full recovery, except for residual left-sided weakness.ConclusionsGeneral physicians should realize that CAAE may be a possible complication of endobronchial electrocautery. Several measures, including avoiding positive pressure, lowering ventilatory pressures if possible, avoiding advancing the bronchoscope to occlude the bronchus and using the non-contact technique, should be used to prevent this devastating complication.
Highlights
Endobronchial electrocautery is a common and safe therapeutic endoscopic treatment for malignant airway obstruction
General physicians should realize that Cerebral arterial air embolism (CAAE) may be a possible complication of endobronchial elec‐ trocautery
Therapeutic endoscopic treatment may be considered for use in malignant airway obstruction, such as endobronchial electrocautery, argon plasma coagulation (APC), and thermal lasers
Summary
General physicians should realize that CAAE may be a possible complication of endobronchial elec‐ trocautery.
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