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A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Cardiac arrest in the neonate during laparoscopic surgery
1Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR 97239, USA. lalwanik@ohsu.edu
Anesthesia and Analgesia
|August 20, 2009
Summary
Neonatal cardiac arrest during laparoscopic surgery can be caused by venous gas embolism. Early diagnosis via echocardiography and preventive measures like avoiding umbilical vessels are crucial for infant safety.
Area of Science:
- Pediatric Surgery
- Neonatal Critical Care
- Minimally Invasive Surgery
Background:
- Laparoscopic surgery in neonates presents unique challenges.
- Intraoperative complications require prompt recognition and management.
Observation:
- A case of neonatal cardiac arrest occurred during attempted laparoscopic surgery before insufflation.
- Initial presentation mimicked other causes of circulatory collapse.
Findings:
- Emergent transthoracic echocardiography revealed intracardiac gas bubbles.
- Diagnosis of venous gas embolism was confirmed.
- The likely source was a bleeding umbilical vein transected by the umbilical trocar.
Implications:
- Increased awareness of venous gas embolism in neonates undergoing laparoscopy is essential.
- Preventive strategies include avoiding umbilical vessels and using open access techniques.
- Prompt ligation of bleeding vessels post-peritoneal access is recommended.
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