Systemic gas embolism in three cases of CT-guided percutaneous lung puncture under general anesthesia: case reports and literature review

These cases illustrate that CT-guided percutaneous lung puncture under general anesthesia carries both benefits and risks. Gas embolism may occur during the biopsy procedure, and if not promptly detected under general anesthesia, it could potentially lead to cardiac arrest. Hybrid operating rooms general anesthesia helps streamline workflow but may mask early signs of air embolism and pose specific risks. Key prevention and management strategies are extremely important, including routine single-lung isolation with the use of a double-lumen endotracheal tube or bronchial blocker, keeping the operated lung at low continuous positive airway pressure (CPAP) during puncture with minimal needle passage, and CT surveillance immediately after surgery. Multidisciplinary coordination, vigilant monitoring, and prompt intervention, including repositioning of the patient and administration of 100% oxygen, are essential to mitigate serious outcomes.