Cerebral Air Embolism during Pleural Lavage

Abstract

Intrapleural fibrinolytic therapy（IFT）is sometimes performed to treat encapsulated pleural effusion associated with empyema in order to avoid surgery. The following is a case of cerebral air embolism during pleural lavage after IFT. A 49-year-old man was found to have encapsulated pleural effusion during treatment for empyema. Intrapleural administration of urokinase was performed for six consecutive days. During a pleural lavage performed two days later, the patient developed loss of consciousness and left paralysis, and was diagnosed with cerebral air embolism. The patient was given edaravone because hyperbaric oxygen therapy was difficult to perform, but disturbance of consciousness remained. It should be taken into consideration that cerebral air embolism is a rare but serious complication of intrapleural fibrinolytic therapy and pleural lavage.