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PATIENT SAFETY

Massive Systemic Air Embolism During Percutaneous Radiofrequency Ablation of a Primary Lung Tumor

Aude Jeannin, MD^*, Pierre Saignac, MD^*, Jean Palussière, MD, Jean-Pierre Gékière, MD^*, Edouard Descat, MD, and Fabrice Lakdja, MD^*

From the *Départments of Anesthesiology and Intensive Care, and Interventional Radiology, Institut Bergonié, Regional Cancer Center, Bordeaux, France.

Address correspondence and reprint requests to Pierre Saignac, MD, Department of Anesthesiology and Intensive Care, Institut Bergonié, Regional Cancer Centre, 229 cours de l’Argonne, 33076 Bordeaux Cedex, France. Address e-mail to saignac{at}bergonie.org.

Abstract

We report the case of a systemic air embolism occurring during pulmonary radiofrequency ablation. At the end of the procedure, the patient experienced a sudden myocardial infarction, complicated by ventricular fibrillation, cardiac arrest, and cerebral infarction. Thoracic computed tomography showed an air-blood level inside the left atrium and ventricle, the aortic arch, and the coronary arteries. Cerebral computed tomography showed an infarct in the frontoparietal area. Myocardial infarction and stroke responded to resuscitation measures, including hyperbaric oxygenation. The occurrence of this life-threatening event confirms the need to train experienced anesthesiologists in these new invasive approaches to cancer treatment.