Cerebral carbon dioxide embolism after kidney cancer laparoscopic surgery with full neurological recovery

Li, Yuan; Zhang, Enlong; Yuan, Huishu

doi:10.1097/md.0000000000020986

Cited by 8 publications

(6 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Li et al . reported cerebral infarction case due to CO 2 embolism after laparoscopic partial nephrectomy, which was associated with postoperative hemiparesis, vomiting, and deep sedation 6 …”

Section: Discussionmentioning

confidence: 97%

“…Li et al reported cerebral infarction case due to CO 2 embolism after laparoscopic partial nephrectomy, which was associated with postoperative hemiparesis, vomiting, and deep sedation. 6 Effective imaging examinations in gas embolism include TEE and CT, which can confirm gas in vessels. 4,7 It is difficult to obtain CT scan intraoperatively.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Carbon dioxide gas embolism during robot‐assisted laparoscopic partial nephrectomy

et al. 2022

View full text Add to dashboard Cite

Introduction One of the complications of laparoscopic surgery is gas embolism, which has low incidence but high mortality. Carbon dioxide embolism diagnosed during robot‐assisted laparoscopic partial nephrectomy has been experienced. Case presentation 77‐year‐old woman with a left renal tumor received robot‐assisted laparoscopic partial nephrectomy. End‐tidal carbon dioxide pressure and oxygen saturation of peripheral artery suddenly decreased 5 min after the start of tumor resection with pneumoperitoneum pressure of 15 mmHg and positive end‐expiratory pressure turned off. Therefore, pulmonary artery gas embolism was diagnosed. The pneumoperitoneum pressure was dropped, and positive end‐expiratory pressure was restarted. These conditions improved and the procedure was completed. Conclusion Carbon dioxide gas embolism during robot‐assisted partial nephrectomy should be focused on because prompt diagnosis and treatment will improve life outcomes. The optimal pneumoperitoneum pressure for each case, rather than making it uniform, should be reconsidered.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Carbon dioxide gas embolism during robot‐assisted laparoscopic partial nephrectomy

et al. 2022

View full text Add to dashboard Cite

show abstract

“…While gas emboli are already a rare complication, those traveling to the cerebral vasculature, as observed in our patient, are even rarer and can precipitate a stroke or transient ischemic attack (TIA). The reported incidence rate of gas embolism following laparoscopic procedures is as low as 0.15%, with an estimated mortality rate as high as 30% [ 6 ]. Kulkarni et al.…”

Section: Discussionmentioning

confidence: 99%

Stroke Secondary to Air Embolism Following Laparoscopic Nissen Fundoplication

Penney,

Park,

Miller

et al. 2024

Cureus

View full text Add to dashboard Cite

An air embolism is characterized by the entry of gas bubbles into the circulatory system, which can lead to the possible occlusion of blood vessels, posing a potentially life-threatening risk. While commonly associated with lung trauma or decompression sickness, it can also result from medical procedures such as central venous catheter insertion or, in our case, gas insufflation for laparoscopic surgery. We present the case of a 65-year-old female who suffered from a stroke secondary to an air embolism after undergoing a laparoscopic Nissen fundoplication in which carbon dioxide insufflation of the abdominal cavity was utilized. We also will discuss the elusive etiology of this complication as well as diagnosis, treatment, and proposed preventative measures. A 65-year-old female with gastroesophageal reflux disease and a hiatal hernia elected to undergo a laparoscopic Nissen fundoplication for hernia repair. After a successful surgery, the patient was found with significant neurological deficits, including left-sided hemiplegia, numbness in the left hand, hemianopsia, dysarthria, and a National Institutes of Health Stroke Scale score of 20. CT head imaging revealed several low-density foci in the right frontal lobe, while CT neck and chest imaging revealed subcutaneous emphysema and pneumomediastinum. Subsequent labs were significant for an elevated lactate at 7.6 mmol/L. MRI of the brain depicted evidence of an acute infarct in the right frontal lobe with diffusion-weighted imaging (DWI) sequences. The imaging results were correlated with the patient's clinical presentation to establish the diagnosis of a nondominant hemisphere stroke, localized to an anterior branch of the right middle cerebral artery (MCA). After intubation and supportive treatment for three days, the patient was extubated and able to follow commands but had left facial weakness and diminished strength in the left upper and lower extremities. At the two-month follow-up visit, the patient no longer had any focal neurological deficits. Air emboli, though very rare, can occur as a complication in laparoscopic surgeries that utilize CO 2 for body cavity insufflation. Patients may be asymptomatic with small, self-limiting emboli, while others may exhibit pulmonary symptoms, cardiac arrest, or focal neurologic changes, depending on the emoji’s size and location. Given the wide range of patient presentations, the elevated mortality of laparoscopic procedures complicated by air emboli, and the rare occurrence of focal neurological symptoms as depicted in this case, rapid diagnosis and close postoperative observation and treatment are vital for both short-term and long-term patient outcomes.

show abstract

“…CO2 embolism may be asymptomatic but can lead to neurologic injury, cardiovascular collapse, and even death. The presentation of CO2 embolism depends on the speed and volume of the embolized gas that enters the blood [7].…”

Section: Discussionmentioning

confidence: 99%

Cardiac Arrest due to Carbon Dioxide Embolism During Laparoscopic Gynecologic Surgery of a Patient with Previous Abdominal Surgery: A Case Report

Kim

2021

Soonchunhyang Med Sci

View full text Add to dashboard Cite

Catastrophic carbon dioxide (CO2) embolism is a rare, but potentially life-threatening, the complication of laparoscopic gynecologic surgery. We report the case of a healthy 53-year-old woman who developed CO2 embolism and cardiac arrest during laparoscopic surgery. She had a history of two cesarean sections and had extensive peritoneal adhesions. After placement of the trocar and insufflation of CO2, end-tidal CO2 dropped from 35 to 15 mm Hg, and the patient had a cardiovascular collapse. In this patient, CO2 embolism was diagnosed on the basis of a sudden decrease in end-tidal CO2, hypotension, and hypoxemia. The patient was managed quickly and aggressively. The patient recovered completely following the treatment for CO2 embolism, with no cardiopulmonary or neurological sequelae. There is an increased risk of catastrophic CO2 embolism during laparoscopic gynecologic surgery in patients with previous abdominal surgery. Therefore, the surgeon and anesthesiologist should remain vigilant to promote early detection of CO2 embolism.

show abstract

Cerebral carbon dioxide embolism after kidney cancer laparoscopic surgery with full neurological recovery

Cited by 8 publications

References 19 publications

Carbon dioxide gas embolism during robot‐assisted laparoscopic partial nephrectomy

Carbon dioxide gas embolism during robot‐assisted laparoscopic partial nephrectomy

Stroke Secondary to Air Embolism Following Laparoscopic Nissen Fundoplication

Cardiac Arrest due to Carbon Dioxide Embolism During Laparoscopic Gynecologic Surgery of a Patient with Previous Abdominal Surgery: A Case Report

Contact Info

Product

Resources

About