Systemic Air Embolism Following Computed Tomography-Guided Lung Biopsy

Area of Science:

• Cardiology
• Neurology
• Pulmonology

Background:

• A 61-year-old male with a history of tongue squamous cell carcinoma underwent a computed tomography (CT)-guided lung biopsy for bilateral lung nodules detected on positron emission tomography (PET) scan.
• The patient had completed chemo-radiation therapy for his primary cancer.

Observation:

• During the lung biopsy procedure, sequential chest scans revealed an air-fluid level in the left ventricle, indicating a potential air embolism.
• The patient remained hemodynamically stable throughout the initial part of the procedure.

Findings:

• Following the biopsy, the patient developed acute right-sided face and arm weakness with aphasia, suggestive of a cerebrovascular event.
• Emergent CT scans of the head and neck, including angiography, ruled out intracranial bleeding or air embolism.
• Treatment with 100% oxygen resulted in rapid resolution of neurological deficits within 30 minutes.

Implications:

• This case highlights a rare complication of air embolism during CT-guided lung biopsy.
• Timely recognition and conservative management with oxygen can lead to favorable neurological outcomes.
• Further investigation into preventative measures during lung biopsies in patients with potential venous access is warranted.