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Canadian Journal of Anesthesia, Vol 31, 455-459, Copyright © 1984 by Canadian Anesthesiologists' Society

Clinical Reports: Capnography in the Early Diagnosis of Carbon Dioxide Embolism during Laparoscopy

DAVID SHULMAN BSC MD CCFP1 and H. B. ARONSON MB FFARCS(I)1

1 Department of Anaesthesia, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel

Address correspondence to: Dr. D. Shulman, Dept. of Anaesthesia, Hadassah University Hospital, Mount Scopus, P.O. Box 24035, Jerusalem, Israel 91240.

Venous embolism of carbon dioxide occurred during elective diagnostic laparoscopy in a healthy adult female. The diagnosis of gas embolism was made on the basis of the sudden abrupt onset of systolic and diastolic murmurs. The continuously recorded end-tidal carbon dioxide concentration (FetCO2) increased abruptly from 3.8 to 4.2 per cent and then slowly decreased to 4.0 per cent over the subsequent 30 seconds. CO2 insufflation was terminated immediately following the establishment of the diagnosis. The patient recovered uneventfully. A transient but rapid rise in FetCO2 is suggested as a useful early sign of venous CO2 embolism during laparoscopy.

Key Words: COMPLICATIONS • gas embolism, carbon dioxide embolism • MONITORING • end-tidal carbon dioxide






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Copyright © 1984 by the Canadian Anesthesiologists' Society.