Systemic air embolism following induction of artificial pneumothorax under anaesthesia, with successful management

Systemic air embolism occurred in a patient during general anaesthesia, with positive pressure ventilation, following induction of artificial pneumothorax to assist in the diagnosis of a mediastinal mass. A sudden change in vital signs together with neurological abnormalities suggested involvement of both coronary and cerebral arteries. A trace of blood was noticed in the syringe which the surgeon had used to create the artificial pneumothorax. The patient was treated with hyperbaric oxygen and recovered satisfactorily, despite a 10-h interval between the air embolus and the institution of definitive therapy.