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Scand J Trauma Resusc Emerg Med ; 20: 51, 2012 Aug 03.
Article in English | MEDLINE | ID: mdl-22862957

ABSTRACT

Venous gas embolism is common after laparoscopic surgery but is only rarely of clinical relevance. We present a 52 year old woman undergoing laparoscopic treatment for liver cysts, who also underwent cholecystectomy. She was successfully extubated. However, after a few minutes she developed cardiac arrest due to a venous carbon dioxide (CO2) embolism as identified by transthoracic echocardiography and aspiration of approximately 7 ml of gas from a central venous catheter. She was resuscitated and subsequently treated with hyperbaric oxygen to reduce the size of remaining gas bubbles. Subsequently the patient developed one more episode of cardiac arrest but still made a full recovery. The courses of events indicate that bubbles had persisted in the circulation for a prolonged period. We speculate whether insufficient CO2 flushing of the laparoscopic tubing, causing air to enter the peritoneal cavity, could have contributed to the formation of the intravascular gas emboli. We conclude that persistent resuscitation followed by hyperbaric oxygen treatment after venous gas emboli contributed to the elimination of intravascular bubbles and the favourable outcome for the patient.


Subject(s)
Cysts/surgery , Embolism, Air/etiology , Hyperbaric Oxygenation , Laparoscopy/adverse effects , Liver Diseases/surgery , Carbon Dioxide , Female , Heart Arrest/etiology , Humans , Iatrogenic Disease , Middle Aged , Recurrence , Veins
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