January 2020 critical care case of the month: a code post lung needle biopsy

• Main Authors: Savajiyni S, Singarajah CU
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2019-12-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: arterial air embolism; air embolism; air embolus; ct scan; treatment; needle biopsy; complication; lung needle biopsy; patient positioning; hyperbaric oxygen
• Online Access: http://www.swjpcc.com/critical-care/2020/1/1/january-2020-critical-care-case-of-the-month-a-code-post-lun.html

No abstract available. Article truncated after first page. A 67-year-old man with a history of stage IIA rectal adenocarcinoma post neoadjuvant chemoradiation presented with a near code event after elective CT guided biopsy of an enlarging left lower lobe lung nodule. The patient became bradycardic and profoundly hypotensive immediately after the CT guided biopsy with the following vital signs: Systolic BP < 90 mmHg, HR 40/min sinus bradycardia, SpO2 on 100% oxygen non rebreather was 90%. Telemetry and EKG showed ST elevation in the anterior leads. He complained of vague arm and leg weakness and tingling, but did not lose consciousness or suffer a cardiac arrest. A CT scan was performed about 2-3 minutes after the patient deteriorated (Figure 1). What radiographic finding likely explains the patient’s clinical deterioration? 1. Arterial air embolism 2. Pneumothorax 3. Pulmonary edema 4. Pulmonary Embolism 5. Venous air embolism …