Cerebral Arterial Air Embolism after Diagnostic Flexible Fiberoptic Bronchoscopy: A Case Report and Review of the Literature

Table 1

The profiles of the patients who developed CAAE after diagnostic flexible fiberoptic bronchoscopy.

Reference number	[4]	[5]	[6]	[6]	[7]	[8]	[9]	[10]
Author and year	Shetty et al. 2001	Dhillon et al. 2004	Azzola et al. 2010	Azzola et al. 2010	Ragey et al. 2013	Evison et al. 2014	Goto et al. 2014	Tsuji et al. 2017	This case
Patient characteristics
Age	60	55	60	68	70	84	69	51	77
Sex	Male	Male	Female	Female	Male	Female	Male	Male	Male
Underlying disease	N/A	COPD	N/A	N/A	COPD	N/A	N/A	COPD	COPD
Smoking history (pack-years)	N/A	N/A	N/A	N/A	30	N/A	0	30	55
Suspected disease	IPF	Lung cancer	Lung cancer	Lung cancer	Lung cancer	Lung cancer	Lung cancer	Tuberculosis	Lung cancer
Cavity in the mass	N/A	N/A	N/A	N/A	(−)	(−)	(−)	(+)	(+)
Bronchoscopy
Examined lobe	N/A	RLL	LUL	RLL	LUL	RUL	LUL	RUL	RLL
Procedure	TBLB	TBNA, TBLB	TBNA, brush cytology, TBB	Brush cytology, TBNA	Brush cytology, TBNA	TBLB	TBNA, TBLB	Curettage, TBLB	Curettage
Positioning	N/A	Supine	N/A	N/A	N/A	N/A	Left lateral	Supine	Left lateral
Bleeding	N/A	50 mL	N/A	Minor	Little	N/A	Middle	Little	Little
Sedation	N/A	Meperidine, midazolam	Midazolam, hydrocodone	Hydrocodone, propofol	(−)	Midazolam, alfentanil	Pethidine	(−)	Midazolam
Diagnosis, treatment, and outcome of CAAE
Lesion of infarction	Bilateral	Right frontal	Bilateral	Left hemisphere	Right hemisphere	Bilateral	Right postal	Left occipital	Right hemisphere
Air bubbles in the CT images	(+)	(+)	(+)	(+)	(−)	(+)	(+)	(+)	(+)
Oxygen delivery	HBO2	NBO2	HBO2	Intubation	HBO2	NBO2	HBO2	N/A	NBO2
Seizure	(+)	(+)	N/A	N/A	(+)	(+)	(−)	N/A	(+)
Outcome	Dead	Completely recovered	Dead	Dead	Completely recovered	Alive	Almost improved	Completely recovered	Partially improved

N/A, not available; COPD, chronic obstructive pulmonary disease; IPF, idiopathic pulmonary fibrosis; LUL, left upper lobe; TBLB, transbronchial lung biopsy; RUL, right upper lobe, RLL, right lower lobe; TBNA, transbronchial needle aspiration; TBB, transbronchial biopsy; HBO2, hyperbaric oxygen; NBO2, normobaric oxygen.