Doctors from Australia are reporting an unusual case of a chest cavity fire in a 60-year-old man associated with an air leak due to a ruptured bulla.
The incident occurred in August 2018, when the patient presented for emergency repair of an ascending aortic dissection. The patient had a history of chronic obstructive pulmonary disease (COPD) and had undergone coronary artery bypass grafting (CABG) one year previously.
The surgeons noted that the patient’s right lung was adherent to the overlying sternum with prominent bullae and despite careful dissection, one of these bullae was punctured during sternotomy causing a significant air leak. To prevent respiratory distress, the flows of anaesthetic gases were increased to 10 litres per minute and the proportion of oxygen to 100 per cent. Soon after, a spark from the electrocautery device ignited a dry surgical pack.
While the fire was immediately extinguished without any injury to the patient, Dr Ruth Shaylor and colleagues from Austin Health in Melbourne, where the incident took place, have warned that the case highlights the potential dangers of dry surgical packs in the oxygen-enrich environment where electrocautery devices are used.
The case was presented at the 2019 Euroanaesthesia Congress.