Fatal massive cerebral air embolism in a lung transplant patient

Edgar A Samaniego; May Anne Kim; Christine A C Wijman

doi:10.1007/s12028-009-9257-1

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Fatal massive cerebral air embolism in a lung transplant patient

Journal article

Peer reviewed

Fatal massive cerebral air embolism in a lung transplant patient

Edgar A Samaniego, May Anne Kim and Christine A C Wijman

Neurocritical care, Vol.11(3), pp.381-383

12/2009

DOI: 10.1007/s12028-009-9257-1

PMID: 19649748

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Abstract

Massive air embolism has been described in multiple clinical scenarios, especially in critical ill patients who undergo invasive procedures. Nevertheless, air embolism is often unrecognized and a high index of suspicion is required to diagnose this entity. Two previous cases of air embolism in lung transplant patients have been described in the literature; we describe a third case of fatal massive air embolism and cardiovascular collapse in a lung transplant patient. Case report. A 52-year-old woman who had a left lung transplant 18 months before admission presented with generalized convulsions and altered mental status. Forty-eight hours after admission and treatment of status epilepticus, she became severely hypotensive and her neurological status deteriorated to brain death. An electrocardiogram showed diffuse ST elevations and a non-contrast head computed tomography demonstrated intravascular air and cerebral edema. Inspection of her intravenous lines did not reveal any leakage or possible port of air entry. An autopsy did not reveal a source of air embolism. Although autopsy did not identify a source for air we suspect that the air originated from the transplanted lung. This case underscores the potential severe consequences of air embolism and its systemic manifestations. A high index of suspicion for cerebral air embolism is warranted in lung transplant patients who present with neurological symptoms.

Postoperative Complications - etiology

Humans

Middle Aged

Status Epilepticus - etiology

Tomography, X-Ray Computed

Lung Transplantation - adverse effects

Postoperative Complications - diagnosis

Status Epilepticus - diagnosis

Embolism, Air - diagnosis

Alveolitis, Extrinsic Allergic - surgery

Fatal Outcome

Electrocardiography

Female

Embolism, Air - etiology

Details

Title: Subtitle: Fatal massive cerebral air embolism in a lung transplant patient
Creators: Edgar A Samaniego - Stanford Stroke Center, Stanford University Medical Center, 701 Welch Rd Ste 325, Bldg B, Palo Alto, CA 94304-1702, USA. esamanie@stanford.edu
May Anne Kim
Christine A C Wijman
Resource Type: Journal article
Publication Details: Neurocritical care, Vol.11(3), pp.381-383
Publisher: United States
DOI: 10.1007/s12028-009-9257-1
PMID: 19649748
ISSN: 1541-6933
eISSN: 1556-0961
Language: English
Date published: 12/2009
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984020790402771

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4 Times Cited - Web of Science