Carbon dioxide and argon gas embolism during laparoscopic hepatic resection

• Published in: Acta anaesthesiologica Scandinavica Vol. 51; no. 7; pp. 949 - 953
• Main Authors: Min, S. K., Kim, J. H., Lee, S. Y.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-08-2007; Blackwell
• Subjects: Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Argon; Argon beam coagulation system; Biological and medical sciences; Carbon Dioxide; Cholestasis, Intrahepatic - surgery; Echocardiography, Transesophageal; Embolism, Air - etiology; Female; Heart Arrest - physiopathology; Humans; Intraoperative Complications - etiology; Laparoscopy; Liver - surgery; Medical sciences; Middle Aged; Oximetry; Postoperative Complications - therapy; Pulmonary Edema - etiology; Pulmonary Edema - therapy; Venous gas embolism; Vascular disease; Air embolism; Venous gas embolism; Liver; Carbon dioxide; Cardiovascular disease; Anesthesia; Laparoscopy; Argon beam coagulation system
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1111/j.1399-6576.2007.01361.x

During laparoscopic hepatic resection, an abrupt decrease in FE’CO2 (from 28 mmHg to 9 mmHg) associated with near cardiac arrest occurred concomitantly with hepatic vein laceration and the use of an argon beam coagulator system. During venous gas embolism, transesophageal echocardiography (TEE) proved the transpulmonary passage of the gas. In the post‐operative period, the patient developed pulmonary edema and made a full recovery after 5 days. This is a case report of a possible paradoxic carbon dioxide (CO2) and argon gas embolism by transpulmonary passage during laparoscopic hepatic resection.