Successful resuscitation after carbon dioxide embolism during laparoscopy.
Venous air embolism (VAE) is a rare life-threatening complication that can occur during laparoscopy. A 50-year-old previously healthy woman underwent laparoscopic cholecystectomy and liver cyst fenestration. Immediately after the surgeon had left the operating room, the patient became hypotensive and developed cardiac arrest. Resuscitation was initiated and a precordial ultrasound examination suspected VAE in the right cardiac chambers. The patient was positioned in Durant's position and air was aspirated through a central venous line. The patient was resuscitated and stabilized, and was transferred to another hospital, where she received hyperbaric oxygen treatment. The patient was discharged 14 days after surgery without any sequelae. It is important that the general surgeon suspects VAE during laparoscopy whenever the patient develops sudden and unexplained severe hypotension or cardiac arrest during or immediately after laparoscopy.
Department of Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark. jakobburcharth@gmail.com
Jakob
J
Burcharth
Stefan
S
Burgdorf
Ida
I
Lolle
Jacob
J
Rosenberg
D002245:Carbon Dioxide / Q000009:adverse effects*; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D003560:Cysts / Q000601:surgery; D004618:Embolism, Air / Q000209:etiology*; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006331:Heart Diseases / Q000209:etiology*; D006801:Humans; D008107:Liver Diseases / Q000601:surgery; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects
D002245:Carbon Dioxide