title: Pneumoperitoneum for neonatal laparoscopy: how safe is it?
abstract: We present the case of a 3 day old term neonate who experienced a cardiopulmonary arrest during creation of pneumoperitoneum for laparoscopic repair of duodenal atresia. The arrest was thought likely to have occurred as a result of a gas embolism. We discuss the features of the neonatal circulation which may predispose neonates to embolic phenomena during laparoscopic procedures, and the potential benefit of priming the insufflation apparatus with carbon dioxide. The possibility of gas embolism should be considered when contemplating laparoscopic surgery in this patient group.
authors.affiliation: Department of Children's Anesthesia, Women's and Children's Hospital, North Adelaide, SA, Australia. melanie.olsen@health.sa.gov.au
authors.forename: Melanie
authors.initials: M
authors.lastname: Olsen
authors.forename: Nicole
authors.initials: N
authors.lastname: Avery
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Khurana
authors.forename: Rob
authors.initials: R
authors.lastname: Laing
mesh_terms: D000768:Anesthesia, General; D003490:Cyanosis / Q000209:etiology; D004385:Duodenostomy; D004386:Duodenum / Q000601:surgery; D004618:Embolism, Air / Q000209:etiology* / Q000628:therapy; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects* / Q000379:methods*; D011182:Postoperative Care