Flexible bronchoscopy is a widely used and safe procedure with a reported maximal mortality rate of 0.04% and a major-complications rate of 0.5%. There are, however, only few case descriptions for postinterventional cerebral air embolism and the frequency of this supposedly rare complication is unknown. The current study presents 2 patients with non-small cell lung cancer who suffered fatal cerebral air embolism following diagnostic bronchoscopy with transbronchial needle aspiration and transbronchial biopsy, resulting in a frequency of <0.02% for this severe complication in our institution. In addition to early supportive measures, 1 patient received hyperbaric oxygen therapy as further treatment. Prompt recognition of this complication is mandatory in order to implement appropriate supportive measures. High-flow oxygen should be administered and hyperbaric oxygen therapy may be considered, if available. If possible, positive pressure ventilation should be avoided.

Keywords:
Air embolism, Bronchoscopy, Complications, Transbronchial biopsy, Transbronchial needle aspiration
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© 2010 S. Karger AG, Basel
2010
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