Abstract
Fibrobronchoscopy is commonly considered a safe procedure with a low major complication rate not including cerebral arterial gas embolism (CAGE) a severe life threatening iatrogenic complication. Several cases of transbronchial needle aspiration (TBNA) has been related with CAGE when patient happens to have the high airway pressure that exceeds the pressure of the pulmonary veins allowing the air to enter the systemic circulation through the left heart. HBOT is the only effective treatment available for CAGE that provides 100% oxygen at high pressure, which accelerates nitrogen reabsorption and improves oxygenation of ischemic tissue. We reported a case of successful treatment with full recovery after early Hyperbaric Oxygen therapy of CAGE induced by an uneventful transbronchial biopsy during fibrobronchoscopy.
Highlights
Fibrobronchoscopy is commonly considered a safe procedure with a low major complication rate of 0.74% [1] that does not include Cerebral arterial gas embolism (CAGE) [2], a severe life threatening iatrogenic complication occasionally reported during invasive procedures, including fibrobronchoscopy [35]
We reported a case of successful treatment with Hyperbaric oxygen therapy (HBOT) of CAGE induced by transbronchial biopsy during fibrobronchoscopy
We reported a case of a severe CAGE following an uneventful fibrobronchoscopy and biopsies
Summary
Fibrobronchoscopy is commonly considered a safe procedure with a low major complication rate of 0.74% [1] that does not include CAGE [2], a severe life threatening iatrogenic complication occasionally reported during invasive procedures, including fibrobronchoscopy [35].HBOT is the only effective treatment [6] available for Cerebral arterial gas embolism (CAGE) that provides 100% oxygen at high pressure, which accelerates nitrogen reabsorption and improves oxygenation of ischemic tissue.We reported a case of successful treatment with Hyperbaric oxygen therapy (HBOT) of CAGE induced by transbronchial biopsy during fibrobronchoscopy.A 75-year-old man with history of hemoptysis underwent computed tomography (CT) scanning and was found to have two lung opacities with irregular margins involving the hilar portion of the right upper and middle lobes. HBOT is the only effective treatment [6] available for Cerebral arterial gas embolism (CAGE) that provides 100% oxygen at high pressure, which accelerates nitrogen reabsorption and improves oxygenation of ischemic tissue. We reported a case of successful treatment with Hyperbaric oxygen therapy (HBOT) of CAGE induced by transbronchial biopsy during fibrobronchoscopy. A Trans bronchial needle aspiration (TBNA) was performed at the level of the subcarinal and hilar nodes at the site of the mild bronchial restriction.
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