[Arterial air embolism during anesthesia for percutaneous pulmonary node location: case report.].

Background And Objectives: Arterial air embolism is a complication that may occur during several surgical procedures and is associated to a high morbidity and mortality rate. This report aimed at presenting a case of arterial air embolism during general anesthesia for percutaneous CT-guided location of a pulmonary node.

Case Report: Male patient, 33 years old, physical status ASA II, was submitted to percutaneous location of a pulmonary node (probably a femoral giant cell tumor metastasis) with the hook-wire technique under general anesthesia. Anesthesia was induced without difficulties and the procedure was started with the patient in the right lateral position. After hook insertion, while the surgeons checked its positioning with CT images, arterial hypotension and bradycardia followed by asystole was observed. Cardiopulmonary resuscitation maneuvers, thoracic drainage and transthoracic echocardiography were performed. The presence of air in the descending aorta was seen at a later CT image. Cardiac arrest was reversed 15 minutes after resuscitation maneuvers. Patient was referred to the ICU and discharged 6 days later without sequelae.

Conclusions: Arterial air embolism is a complication of different procedures most of them performed with the patient under general anesthesia. Anesthesiologists must be prepared to recognize involved problems and make the differential diagnosis. Suitable and adequate treatment is critical to decrease morbidity and mortality associated to this event.