Successful resuscitation after catastrophic carbon dioxide embolism during laparoscopic cholecystectomy

Haroun-Bizri, Sania; ElRassi, T.

doi:10.1097/00003643-200102000-00010

Cited by 18 publications

(6 citation statements)

References 18 publications

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“…483 Additional care is needed to prevent carbon dioxide embolization to the lungs, which is not tolerated well in these patients, and to avoid paradoxical embolization, which can occur through a persistent Fontan fenestration or right-to-left shunting from venous collaterals. [484][485][486] Because abdominal insufflation can lead to hypercarbia or increased intrathoracic pressures, either of which may lead to a drop in cardiac output, intra-arterial lines are frequently placed. Central venous access is used for longer procedures with larger volume shifts to allow rapid fluid resuscitation and central venous pressure measurements.…”

Section: Perioperative Managementmentioning

confidence: 99%

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Lui¹,

Saïdi²,

Bhatt³

et al. 2017

Circulation

176

136

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ABSTRACT:Life expectancy and quality of life for those born with congenital heart disease (CHD) have greatly improved over the past 3 decades. While representing a great advance for these patients, who have been able to move from childhood to successful adult lives in increasing numbers, this development has resulted in an epidemiological shift and a generation of patients who are at risk of developing chronic multisystem disease in adulthood. Noncardiac complications significantly contribute to the morbidity and mortality of adults with CHD. Reduced survival has been documented in patients with CHD with renal dysfunction, restrictive lung disease, anemia, and cirrhosis. Furthermore, as this population ages, atherosclerotic cardiovascular disease and its risk factors are becoming increasingly prevalent. Disorders of psychosocial and cognitive development are key factors affecting the quality of life of these individuals. It is incumbent on physicians who care for patients with CHD to be mindful of the effects that disease of organs other than the heart may have on the well-being of adults with CHD. Further research is needed to understand how these noncardiac complications may affect the long-term outcome in these patients and what modifiable factors can be targeted for preventive intervention.

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Section: Perioperative Managementmentioning

confidence: 99%

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Lui¹,

Saïdi²,

Bhatt³

et al. 2017

Circulation

176

136

View full text Add to dashboard Cite

show abstract

“…12 Additionally, in patients with cardiac diseases or hemodynamic instability, a central venous catheter should be inserted to monitor hemodynamics and remove gas emboli from the right atrium when suspected. 13 Prompt diagnosis and accurate treatment are imperative to improve the prognosis in cases of CO 2 embolization. The basic treatments include immediate cessation of CO 2 insufflation, hyperventilation with an inspired oxygen fraction of 1.0, and inotropic support of hemodynamic function.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Carbon dioxide embolism with severe hypotension as an initial symptom during laparoscopy: a case report

et al. 2021

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Laparoscopy is widely used because it induces minimal postoperative pain and facilitates rapid recovery. However, carbon dioxide (CO2) embolism is a rare but potentially fatal complication of laparoscopic surgery. Earlier reports have shown that decreased end-tidal CO2 (ETCO2) and increased partial pressure of CO2 might be useful indicators of CO2 embolism. We herein report a case of CO2 embolism after the freed bladder neck was released during laparoscopic radical prostatectomy. Sudden hemodynamic disorder and increased ETCO2 combined with immediate arterial blood gas analysis led us to suspect CO2 embolism, which was confirmed by the aspiration of foamy blood from the central venous catheter. The patient was successfully resuscitated and recovered well. This case illustrates that hemodynamic collapse accompanied by increased ETCO2 can indicate CO2 embolism.

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“…Most cases are diagnosed by auscultative or hemodynamic changes and loss of end-tidal CO 2 , followed by successful resuscitation efforts. 1,2,4 Management includes removal of the carbon dioxide source, intravascular volume replacement, inotropic support, and if necessary, chest compressions. Hyperbaric oxygen therapy may be required if there is persistent evidence of gas hours following an embolic event.…”

Section: Discussionmentioning

confidence: 99%

“…Historically, circulatory collapse associated with laparoscopic insufflation has been attributed to carbon dioxide embolism, [1][2][3][4] but the severity of some events is not consistent with intravenous carbon dioxide alone, and nitrogen in air may contribute to sustained hemodynamic decompensation and catastrophic outcomes. We report the case of a 12-day-old infant who suffered a massive embolism during laparoscopic pyloromyotomy, cardiac arrest, and successful resuscitation that included hyperbaric oxygen therapy for documented intracranial arterial gas emboli.…”

Section: Résumémentioning

confidence: 99%

Gas embolus and cardiac arrest during laparoscopic pyloromyotomy in an infant

Taylor

Hoffman

2010

Can J Anesth/J Can Anesth

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Successful resuscitation after catastrophic carbon dioxide embolism during laparoscopic cholecystectomy

Cited by 18 publications

References 18 publications

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Carbon dioxide embolism with severe hypotension as an initial symptom during laparoscopy: a case report

Gas embolus and cardiac arrest during laparoscopic pyloromyotomy in an infant

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