Pulmonary lipiodol embolism during transcatheter arterial chemoembolization for hepatoblastoma under general anaesthesia

被引:20
作者
Yamaura, K [1 ]
Higashi, M [1 ]
Akiyoshi, K [1 ]
Itonaga, Y [1 ]
Inoue, H [1 ]
Takahashi, S [1 ]
机构
[1] Kyushu Univ, Fac Med, Dept Anaesthesiol & Crit Care Med, Higashi Ku, Fukuoka 8128582, Japan
关键词
radiology; interventional; embolism; pulmonary embolism; contrast media; iodized oil; monitoring; intraoperative; pulse oximetry; intraoperative complications;
D O I
10.1046/j.1365-2346.2000.00759.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
We present a case of pulmonary embolism that occurred during the injection of lipiodol during transcatheter arterial chemoembolization under general anaesthesia. A 7-year-old child suffering from a large hepatoblastoma was admitted for arterial chemoembolization and carcinostatic administration. Pulmonary embolism due to lipiodol during arterial chemoembolization was evident by a sudden fall in oxyhaemoglobin saturation from 100 to 90%. This was associated with a spread of lipiodol into both lungs, particularly the middle lung zones and detected by chest fluoroscopy. Arterial blood gases returned to normal values 1 day later but pulmonary infiltration persisted for 7 days before final clearance. Pulmonary embolism caused by lipiodol during arterial chemoembolization is infrequent, but such a complication could prove fatal. Understanding the risk of pulmonary embolism in patients receiving lipiodol, during and after arterial chemoembolization, and late onset pulmonary injury is important and a close follow-up for several days after arterial chemoembolization is advisable.
引用
收藏
页码:704 / 708
页数:5
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