F. Ploner et T. Theiner, CO2-gas-embolism following accidental vessel punction during laparoscopic cholecystectomy, ANAESTHESIS, 48(8), 1999, pp. 538-541
We report a case of carbon dioxide (CO2) embolism in a 52-year-old man duri
ng a laparoscopic cholecystectomy,which caused an accidental CO2-insufflati
on in a vessel despite exact control of the Verres needle. The first manife
stations were two drops of the partial pressure of endtidal carbon dioxide
(PETCO2) from 34 mmHg to 13 mmHg and again from 37 mmHg to 11 mmHg,followed
by pulseless ventricular tachycardia. It was possible to achieve resuscita
tion and a recompensation of the right heart failure with drug therapy. Aft
er successful resuscitation and restoration of a stable hemodynamic situati
on,an abrupt increase in the PETCO2 from 11 mmHg to 52 mmHg was noted. This
increase of PETCO2 could be interpreted as the reinstallation of circulati
on and the amount of CO2 in the organism after carbon dioxide embolism.