Chest
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A 65-year-old patient sustained massive air embolism after the needle used for left atrial pressure line insertion punctured the posterior wall of the superior pulmonary vein, entering the middle lobe bronchus and causing a pulmonary venous-bronchus fistula. This is an apparently heretofore unrecognized potential cause of massive air embolism following cardiac surgery.
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This report presents a patient who developed fulminant pulmonary edema as a complication of an acute subarachnoid hemorrhage. Hemodynamic evaluation revealed low-normal pulmonary arteriolar resistances. Endobronchial fluid was freely suctioned from the patient over a two-day period and had a colloid osmotic pressure and protein content equal to the patient's plasma throughout the entire course. These findings suggest that neurogenic pulmonary edema in this patient was related to increased capillary permeability and may occur independent of pulmonary hemodynamics.