Detection of Carbon Dioxide Embolism Using Transesophageal Echocardiography during Thoracoscopic Sympathicotomy

Park, Chung Hyun; Lee, Jong Yun; Kim, Yong Chan; Kim, Seung Ho; Jung, Keum Hee; Kim, Min Goo; Lee, Hyeon Jae

doi:10.4097/kjae.2006.50.2.173

Cited by 2 publications

(3 citation statements)

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“…Intraoperative significant CO 2 embolism in laparoscopic hepatic surgery is a rare, severe complication and can occur when a blood vessel with a pressure lower than the intra-abdominal pressure is opened [ 6 ]. In venous embolism, emboli pass to the right heart or pulmonary artery/central vein.…”

Section: Discussionmentioning

confidence: 99%

Detection of paradoxical carbon dioxide gas embolism with opening of patent foramen ovale by perioperative transesophageal echocardiography during laparoscopic hepatectomy - A case report -

Kim

Lee

et al. 2022

Anesth Pain Med

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Background: Due to its various advantages, laparoscopic surgery is preferred over laparotomy in patients who require hepatic resection. Carbon dioxide embolism—which occurs approximately ten times more often in laparoscopic hepatectomy than in general laparoscopic surgery—presents with insignificant symptoms and may be overlooked. Case: A 70-year-old male with hepatic cell carcinoma underwent laparoscopic hepatectomy. Though his vital signs were stable during the initiation of surgery, they became unstable during the procedure. The surgeon detected portal vein rupture, and transesophageal echocardiography was subsequently performed. A large amount of gas in the heart chamber and paradoxical embolism through a patent foramen ovale due to a right-to-left shunt were observed. We treated the symptoms, and the surgery was completed without any further issues. Conclusions: Active use of transesophageal echocardiography to identify and monitor heart functions during a suspected carbon dioxide embolism can significantly reduce morbidity and mortality associated with that embolism.

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Section: Discussionmentioning

confidence: 99%

Detection of paradoxical carbon dioxide gas embolism with opening of patent foramen ovale by perioperative transesophageal echocardiography during laparoscopic hepatectomy - A case report -

Kim

Lee

et al. 2022

Anesth Pain Med

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“…Current investigations using TEE indicate that subclinical CO 2 gas embolism is not uncommon during laparoscopic surgery [2,3]. Gas embolism is shown to occur during two distinct periods: first, during peritoneal insufflation, and second, during gallbladder or liver dissection.…”

Section: Discussionmentioning

confidence: 99%

“…It is inexpensive, highly soluble in blood, rapidly eliminated, and noncombustible. Subclinical CO 2 gas embolism with minimal cardiopulmonary instability detected by transesophageal echocardiography (TEE) commonly occurs during laparoscopic surgery [2,3]. Clinically apparent CO 2 gas embolism is a rare but potentially lethal complication of laparoscopic surgery [4-6].…”

mentioning

confidence: 99%

Cardiac arrest associated with carbon dioxide gas embolism during laparoscopic surgery for colorectal cancer and liver metastasis -A case report-

Kim

Jung

Shin

2012

Korean J Anesthesiol

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Clinically apparent carbon dioxide (CO2) gas embolism is uncommon, but it may be a potentially lethal complication if it occurs. We describe a 40-year-old woman who suffered a CO2 gas embolism with cardiac arrest during laparoscopic surgery for colorectal cancer and liver metastasis. Intra-abdominal pressure was controlled to less than 15 mmHg during CO2 gas pneumoperitoneum. The right hepatic vein was accidentally disrupted during liver dissection, and an emergent laparotomy was performed. A few minutes later, the end-tidal CO2 decreased, followed by bradycardia and pulseless electrical activity. External cardiac massage, epinephrine, and atropine were given promptly. Ventilation with 100% oxygen was started and the patient was moved to the Trendelenburg position. Two minutes after resuscitation was begun, a cardiac rhythm reappeared and a pulsatile arterial waveform was displayed. A transesophageal echocardiogram showed air bubbles in the right pulmonary artery. The patient recovered completely, with no cardiopulmonary or neurological sequelae.

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Detection of Carbon Dioxide Embolism Using Transesophageal Echocardiography during Thoracoscopic Sympathicotomy

Cited by 2 publications

References 0 publications

Detection of paradoxical carbon dioxide gas embolism with opening of patent foramen ovale by perioperative transesophageal echocardiography during laparoscopic hepatectomy - A case report -

Detection of paradoxical carbon dioxide gas embolism with opening of patent foramen ovale by perioperative transesophageal echocardiography during laparoscopic hepatectomy - A case report -

Cardiac arrest associated with carbon dioxide gas embolism during laparoscopic surgery for colorectal cancer and liver metastasis -A case report-

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