Bronchoscopic lung insufflation for post-transplant lobar atelectasis: Efficacy and a rare complication of cerebral gas embolism

Respir Investig. 2026 Jan;64(1):101339. doi: 10.1016/j.resinv.2025.101339. Epub 2025 Nov 28.

Abstract

Bronchoscopic lung insufflation (BLI) allows re-expansion of collapsed lung lobes after transplantation. Among 254 transplant cases at our center, two patients underwent BLI for lobar atelectasis. Case 1 had recurrent right middle-lobe collapse after initial recovery, and BLI under conscious sedation led to durable re-expansion without complications. Case 2 underwent BLI for right upper-lobe atelectasis but developed transient neurological deficits due to presumed cerebral gas embolism, despite initial re-expansion. Full recovery was achieved with supportive care. These cases highlight BLI as an effective treatment for post-transplant atelectasis, although rare but serious complications require careful monitoring.

Keywords: Atelectasis; Bronchoscopic lung insufflation; Cerebral gas embolism; Lung transplantation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bronchoscopy* / methods
  • Embolism, Air* / etiology
  • Female
  • Humans
  • Insufflation* / methods
  • Intracranial Embolism* / complications
  • Intracranial Embolism* / etiology
  • Lung Transplantation* / adverse effects
  • Male
  • Middle Aged
  • Postoperative Complications* / etiology
  • Postoperative Complications* / therapy
  • Pulmonary Atelectasis* / etiology
  • Pulmonary Atelectasis* / therapy
  • Treatment Outcome