Cerebral air embolism (CAE) is a common, often lethal, complication in blunt and penetrating chest trauma. The factors affecting the outcome of CAE patients are poorly understood, and there is no generally accepted treatment algorithm. In this report, we present the case of a 28-year-old male motorcyclist with a massive CAE, including bilateral internal carotid artery air on computed tomographic examination following blunt chest trauma. With prehospital intubation, oxygen, transfusion, and open laparotomy but without any specific treatment regarding the CAE, a follow-up computed tomography (CT) scan approximately 6 hours later showed resolution of the cerebrovascular air. Recovery was unremarkable, and the patient was discharged neurologically intact after 22 days.

Respiratory support with high-frequency jet ventilation has been advocated during airway surgery or to improve pulmonary mechanics and gas exchange in patients with bronchopleural fistulae or pulmonary insufficiency. Despite a large body of published evidence describing its benefits as an alternative ventilatory approach in anaesthesia and intensive care medicine, its application has not gained widespread acceptance and is restricted to specialized centres. To review the literature on high-frequency jet ventilation in European and North American institutions, we performed a search in a computerized database (MEDLINE) covering the period from 1990 until the present time, describing the use of high-frequency jet ventilation in over 7000 patients. Various modes to apply high-frequency jet ventilation during airway surgery have been established, but its value in intensive care is controversial. We report our experience with combined high-frequency jet ventilation and provide guidelines for its safe application.