Successful resuscitation alter catastrophic carbon dioxide embolism duringlaparoscopic cholecystectomy

A 92-year-old female was scheduled for laparoscopic cholecystectomy. Follow ing intraperitoneal carbon dioxide insufflation and removal of her gallblad der, the patient developed serious haemodynamic deterioration associated wi th a decrease of both end-tidal carbon dioxide concentration (ETCO2) and ch est compliance. Carbon dioxide embolism was suspected and the diagnosis was confirmed by aspiration of 20 mt of foamy blood from the central venous li ne. The patient was successfully resuscitated after discontinuation of carb on dioxide insufflation and ventilation of the lungs with 100% oxygen. Carb on dioxide embolization must always be suspected during laparoscopic surger y whenever sudden haemodynamic deterioration associated with a decrease in ETCO2 and chest compliance occur.