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Updated: Aug 7, 2025
07:52
Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
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An abrupt decrease in arterial blood pressure may predict a high level carbon dioxide embolism in
Jianwei Wang1, Zhengqing Bao2, Libo Man1
1Department of Urology, Beijing Jishuitan Hospital, No. 31 Xinjiekou East Street, Xicheng District, Beijing, 100035, China.
BMC Urology
|March 7, 2023
Summary
Carbon dioxide (CO2) embolism is a rare but serious complication during retroperitoneal surgery. Prompt recognition and intervention, including stopping CO2 insufflation, are crucial for patient survival.
Area of Science:
- Urology
- Anesthesiology
- Surgical Complications
Background:
- Carbon dioxide (CO2) embolism is a leading cause of intraoperative cardiovascular collapse.
- Reports of CO2 embolism during retroperitoneal laparoscopy are scarce.
Approach:
- A case of retroperitoneoscopic adrenalectomy in a 40-year-old male is presented.
- Sudden hypotension unresponsive to epinephrine prompted investigation.
- Transesophageal echocardiography confirmed gas embolism in the right atrium.
Key Points:
- Diagnosis of intraoperative gas embolism (Grade IV) was confirmed.
- Cessation of CO2 insufflation and deflation of the retroperitoneal cavity resolved the embolism.
- Hemodynamic parameters normalized within 20 minutes.
Conclusions:
- CO2 embolism can occur during retroperitoneoscopic adrenalectomy.
- Acute hypotension during this procedure necessitates consideration of CO2 embolism.
- This rare complication requires vigilance from urologists and anesthesiologists.
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