{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T03:55:13Z","timestamp":1762142113798,"version":"3.44.0"},"reference-count":26,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"abstract":"<jats:p>Gas embolism is a dreaded complication following invasive medical procedures, traumatic lung injury and decompression accidents. We report a case of fatal gas embolism following the use of non-invasive ventilation (NIV) with bilevel positive airway pressure (BiPAP). The patient initially underwent left bronchial artery embolisation for massive haemoptysis in the context of severe tuberculotic sequels. Under NIV and after heavy coughing he became hemiparetic and his level of consciousness suddenly dropped. Computed tomography of the brain showed multiple air embolism and ischaemic lesions were confirmed by magnetic resonance imaging. Echocardiographic investigations showed no intracardiac defect. Vasculo-pulmonary abnormalities in the context of heavy coughing and non-invasive ventilation may have played a major role in the occurrence of this event. New neurological events in a patient with tuberculotic sequels or any known vascular pulmonary abnormalities and NIV should raise the suspicion of brain gas embolism.<\/jats:p>","DOI":"10.1136\/bcr.06.2008.0163","type":"journal-article","created":{"date-parts":[[2008,11,21]],"date-time":"2008-11-21T13:17:58Z","timestamp":1227273478000},"page":"bcr0620080163","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Fatal brain gas embolism during non-invasive positive pressure ventilation"],"prefix":"10.1136","volume":"2008","author":[{"given":"Claire B","family":"Rivara","sequence":"first","affiliation":[{"name":"Geneva University Hospitals (HUG), Internal Medicine, Geneva 14, Switzerland, 1211"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Claude","family":"Chevrolet","sequence":"additional","affiliation":[{"name":"Geneva University Hospitals (HUG), Internal Medicine, Geneva 14, Switzerland, 1211"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvan","family":"Gasche","sequence":"additional","affiliation":[{"name":"Geneva University Hospitals (HUG), Internal Medicine, Geneva 14, Switzerland, 1211"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Charbonney","sequence":"additional","affiliation":[{"name":"Geneva University Hospitals (HUG), Internal Medicine, Geneva 14, Switzerland, 1211"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"2025082802395771000_2008.aug05_1.bcr0620080163.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200002173420706"},{"key":"2025082802395771000_2008.aug05_1.bcr0620080163.2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200701000-00026"},{"key":"2025082802395771000_2008.aug05_1.bcr0620080163.3","doi-asserted-by":"publisher","DOI":"10.1007\/BF02425047"},{"key":"2025082802395771000_2008.aug05_1.bcr0620080163.4","first-page":"403","article-title":"A review of the pathophysiology and potential application of experimental therapies for cerebral ischemia to the treatment of cerebral arterial gas embolism","volume":"12","author":"Dutka","year":"1985","journal-title":"Undersea Biomed Res"},{"key":"2025082802395771000_2008.aug05_1.bcr0620080163.5","first-page":"43","article-title":"Air embolism and spontaneous pneumothorax as an avoidable complication of artificial pneumothorax","volume":"25","author":"Cranz","year":"1950","journal-title":"Acta Tuberc Scand"},{"key":"2025082802395771000_2008.aug05_1.bcr0620080163.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-006-0091-z"},{"key":"2025082802395771000_2008.aug05_1.bcr0620080163.7","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.98.12010235"},{"key":"2025082802395771000_2008.aug05_1.bcr0620080163.8","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1097\/00003246-199107000-00029","article-title":"Cerebral arterial air embolism associated with coughing on a continuous positive airway pressure circuit","volume":"19","author":"Ulyatt","year":"1991","journal-title":"Crit Care Med"},{"key":"2025082802395771000_2008.aug05_1.bcr0620080163.9","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1111\/j.1540-8175.1996.tb00935.x","article-title":"Emboli and neuropsychological outcome following cardiopulmonary bypass","volume":"13","author":"Stump","year":"1996","journal-title":"Echocardiography"},{"key":"2025082802395771000_2008.aug05_1.bcr0620080163.10","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/62.3.243"},{"key":"2025082802395771000_2008.aug05_1.bcr0620080163.11","first-page":"103","article-title":"Gas embolism in obstetrics and gynecology. 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