[Lethal air embolism after spray of tissue adhesive-fibrinogen and factor XIII aerosol during laparoscopic partial nephrectomy].

We report a case of lethal air embolism just after spray of adhesive-fibrinogen and factor XIII aerosol during laparoscopic surgery. A 76-year-old man underwent laparoscopic partial nephrectomy for the left renal cancer. After partial nephrectomy, adhesive-fibrinogen and factor XIII aerosol were sprayed to a bleeding region of the kidney. The blood pressure and the end-tidal carbon dioxide concentration suddenly decreased, followed by cardiac arrest. Trans-esophageal echocardiography and computed tomography after cardiopulmonary resuscitation confirmed multiple air embolism. The use of a spray aerosol during laparoscopic surgery may be associated with the risk of lethal air embolism.