Embolism Risk Analysis—Helium Versus Carbon Dioxide

Abstract

Embolisms with the smallest amounts of helium administered via direct venous puncture have an immediate lethal impact. Extended perioperative monitoring and trocar placement under vision should be performed.

Intra-aortic balloon pump entrapment and surgical removal: a case report

“…Complications associated with balloon perforation such as in this case can be catastrophic. Arterial helium embolism is a documented complication of larger perforations in the balloon membrane allowing a sudden introduction of a large volume of helium into the systemic circulation and resulting in significant neurological deficit and even death 7 , 8 . The use of carbon dioxide in place of helium significantly lowers the risk of embolus, given its increased solubility in blood; however, its higher density means a slower diffusion coefficient and it is therefore not commonly used 9 …”

Anesthesia for Endoscopy

“…9,12,13 CO 2 is the gas most commonly used because it has ideal characteristics: it quickly dissolves in blood, so large amounts can be stored in the blood thus reducing the likelihood of CO 2 thromboembolism; CO 2 is quickly eliminated by exhalation through the lungs; there is no anesthetic effect at clinical concentrations; it is noninflammable; and it does not irritate tissues. 8,9,14 Insufflation of the abdominal cavity with any gas produces pneumoperitoneum, and requires special equipment and techniques.…”