Re-insufflation after deflation of a pneumoperitoneum is a risk factor for CO2 embolism during laparoscopic prostatectomy: A case report / 대한마취과학회지
Korean Journal of Anesthesiology
;
: S201-S206, 2010.
Article
Dans Anglais
| WPRIM
| ID: wpr-202668
ABSTRACT
Although symptomatic carbon dioxide (CO2) embolism is rare, it recognized as a potentially fatal complication of laparoscopic surgery. Sudden hemodynamic instability could be a CO2 embolism especially during insufflation. A 65-year-old man received laparoscopic prostatectomy for 5 hours under CO2 pneumoperitoneum without any problem. After resection of prostate, it was stopped following deflation. Thirty minutes later, peumoperitoneum was re-induced to continue the operation. Shortly after re-insufflation, the patient revealed hemodynamic instability suggested a CO2 embolism; severe hypotension, tachyarrythmia, hypoxemia, increased CVP, and changed end-tidal CO2. Gas insufflation was stopped. He was managed with Durant's position, fluid and cardiotonics for 20 minutes. The residual was completed by open laparotomy. Re-insufflation, inducing gas entry through the injured vessels, might be a risk factor for CO2 embolism in this case. The risk to the patient may be minimized by the surgical team's awareness of CO2 embolism and continuous intra-operative monitoring of end-tidal CO2.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Pneumopéritoine
/
Prostate
/
Prostatectomie
/
Dioxyde de carbone
/
Insufflation
/
Cardiotoniques
/
Facteurs de risque
/
Laparoscopie
/
Embolie
/
Hémodynamique
Type d'étude:
Etude d'étiologie
/
Facteurs de risque
Limites du sujet:
Adulte très âgé
/
Humains
langue:
Anglais
Texte intégral:
Korean Journal of Anesthesiology
Année:
2010
Type:
Article
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