Systemic air embolism following manual lung inflation

A case is reported in which a young man undergoing exploratory thoracotomy following a gunshot wound had a cardiac arrest during reinflation of the collapsed lung. Systemic air embolism was suspected as the cause. Subsequent neurological examination and C.T. scan demonstrated a lesion ascribable to this. Discontinuation of nitrous oxide, aspiration of left heart chambers and a head-down position are recommended as immediate treatment if this diagnosis is made. In cases with piercing lung trauma high inflation pressures should be avoided to prevent embolism.