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Introduction <p>: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is commonly used for diagnosing mediastinal lymphadenopathy. Despite a low complication rate, severe hemorrhage can occur which is reported in this literature, particularly in hypervascular conditions like Castleman disease.</p> Methods <p>A 54-year-old male with idiopathic multicentric Castleman disease underwent EBUS-TBNA for mediastinal lymph node sampling. During the procedure, vascular invasion led to significant bleeding, requiring immediate interventions including suctioning and therapeutic bronchoscopy.</p> Results <p>The patient experienced massive hemorrhage, resulting in airway obstruction, oxygen desaturation, and cardiac arrest. Aggressive resuscitation successfully restored cardiac rhythm after 15&#xa0;min. The patient was then stabilized and transferred to the intensive care unit for monitoring.</p> Conclusions <p>This case underscores the risk of severe hemorrhage in hypervascular conditions during EBUS-TBNA. Pre-procedural imaging, careful planning, and immediate availability of hemostatic measures are crucial to reducing complications and improving outcomes in high-risk patients.</p>

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Massive endobronchial hemorrhage leading to Cardiac arrest during EBUS-TBNA: a case of successful resuscitation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月25日

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  • Ping-Yang Hong,
  • Mao-Hong Huang,
  • Ling Cai,
  • Yi-Yuan Chen,
  • Yu-Xin Guo,
  • Xiao-Bin Zhang

摘要

Introduction

: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is commonly used for diagnosing mediastinal lymphadenopathy. Despite a low complication rate, severe hemorrhage can occur which is reported in this literature, particularly in hypervascular conditions like Castleman disease.

Methods

A 54-year-old male with idiopathic multicentric Castleman disease underwent EBUS-TBNA for mediastinal lymph node sampling. During the procedure, vascular invasion led to significant bleeding, requiring immediate interventions including suctioning and therapeutic bronchoscopy.

Results

The patient experienced massive hemorrhage, resulting in airway obstruction, oxygen desaturation, and cardiac arrest. Aggressive resuscitation successfully restored cardiac rhythm after 15 min. The patient was then stabilized and transferred to the intensive care unit for monitoring.

Conclusions

This case underscores the risk of severe hemorrhage in hypervascular conditions during EBUS-TBNA. Pre-procedural imaging, careful planning, and immediate availability of hemostatic measures are crucial to reducing complications and improving outcomes in high-risk patients.