Successful outcome of massive carbon dioxide embolism during laparoscopic hepatectomy

Zhang, Jun; Zhao, Jie; Fei, Yue; Liu, Tieshuai; Liu, Minjun

doi:10.1016/j.lers.2020.04.001

Cited by 1 publication

(1 citation statement)

References 13 publications

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“…Carbon dioxide (CO 2 ) gas embolism, mainly resulting in significant symptoms or complications, is not common in the past. However, this has been increasingly reported due to the widespread availability of laparoscopic surgery in recent years ( 4 , 5 ). So far, we have not found the exact literature that reported ARDS secondary to CO 2 gas embolism.…”

Section: Introductionmentioning

confidence: 99%

Acute respiratory distress syndrome secondary to carbon dioxide gas embolism after single-port robotic-assisted perineal radical prostatectomy: a case report

Zhu¹,

Chen²,

Wang³

et al. 2022

Transl Cancer Res TCR

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Background: Single-port robotic-assisted perineal radical prostatectomy (spRAPP) can provide oncologic outcomes similar to those with a traditional approach and is especially indicated for patients with prostate cancer who have a history of major abdominopelvic surgery. Few complications associated with this procedure have been reported.Case Description: A 64-year-old man underwent a spRAPP with a sudden decrease in the percutaneous oxygen saturation (SpO 2 ) and the end-tidal carbon dioxide (ETCO 2 ) partial pressure after accidental injury to the right prostatic venous plexus. And the diagnosis of carbon dioxide (CO 2 ) gas embolism was confirmed by transesophageal echocardiography (TEE). By reducing the pneumoperitoneal pressure, closing the venous rupture, increasing the end-expiratory pressure, and elevating the concentration of inhaled oxygen, the patient's oxygenation improved until the end of the operation. However, he progressed to adult acute respiratory distress syndrome (ARDS) postoperatively. The patient was treated with intensive care and recovered well after treatment with pulmonary protective ventilation. This article reports a case of CO 2 embolism confirmed by TEE during spRAPP and resulting in postoperative ARDS, which is the first report in the literature.Conclusions: Anesthesiologists' and surgeons' early detection of CO 2 embolism was the key to effective treatment. ARDS secondary to CO 2 embolism is rare but cannot be ignored and requires intensive care intervention and comprehensive treatment based on a protective pulmonary ventilation strategy.

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Section: Introductionmentioning

confidence: 99%