title: [Thoracoscopic thymectomy with carbon dioxide insufflation in the mediastinum].
abstract: The case is presented of a 71 year-old male, diagnosed with a thymoma. A thoracoscopic thymectomy was performed using the carbon dioxide insufflation technique in the mediastinum. During the procedure, while performing one-lung ventilation, the patient's respiration worsened. The contralateral lung had collapsed, as carbon dioxide was travelling from the mediastinum to the thorax through the opened pleura. Two-lung ventilation was decided upon, which clearly improved oxygenation in the arterial gases and airway pressures. Both pH and pCO2 stabilized. The surgical approach and the carbon dioxide technique were continued because 2-lung ventilation did not affect the surgical procedure. This technique has many serious complications and it should always be performed using 2-lung ventilation.
authors: Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital General Universitario de Alicante, Alicante, España. Electronic address: doctorcferrero@gmail.com.
authors: C
authors: C
authors: Ferrero-Coloma
authors: Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital General Universitario de Alicante, Alicante, España.
authors: J
authors: J
authors: Navarro-Martinez
authors: Servicio de Cirugía Torácica, Hospital General Universitario de Alicante, Alicante, España.
authors: S
authors: S
authors: Bolufer
authors: Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital General Universitario de Alicante, Alicante, España.
authors: M J
authors: MJ
authors: Rivera-Cogollos
authors: Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital General Universitario de Alicante, Alicante, España.
authors: F J
authors: FJ
authors: Alonso-García
authors: Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital General Universitario de Alicante, Alicante, España.
authors: M I
authors: MI
authors: Tarí-Bas
mesh_terms: D000368:Aged; D002245:Carbon Dioxide; D006801:Humans; D007327:Insufflation; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D061810:One-Lung Ventilation; D010994:Pleura / Q000293:injuries; D011012:Pneumomediastinum, Diagnostic / Q000009:adverse effects*; D001261:Pulmonary Atelectasis / Q000209:etiology*; D012131:Respiratory Insufficiency / Q000209:etiology*; D013906:Thoracoscopy / Q000379:methods*; D013934:Thymectomy / Q000379:methods*; D013945:Thymoma / Q000601:surgery; D013953:Thymus Neoplasms / Q000601:surgery
chemical_list: D002245:Carbon Dioxide
keywords: Anestesiología; Anesthesiology; Carbon dioxide; Complicaciones; Complications; Dióxido de carbono; One-lung ventilation; Thoracoscopy; Thymoma; Timoma; Toracoscopia; Ventilación unipulmonar