Carbon Dioxide Embolism

Excerpt

Laparoscopic surgery has gained increasing popularity in clinical practice. As part of laparoscopic surgeries, gas insufflation is usually adopted to increase operative space and visualization for surgeons. The abdomen is the most common location for these laparoscopic interventions, particularly in areas such as gastrointestinal and gynecologic surgeries. Carbon dioxide (CO2) is the most commonly used gas for insufflation during laparoscopic surgery because it is colorless, inexpensive, non-flammable, and has higher blood solubility than air, which reduces the risk of complications if venous embolism occurs.

The use of CO2 gas for insufflation presents some risk. Among the most common complications associated with CO2 insufflation is CO2 embolism. Although CO2 microembolism commonly occurs during laparoscopy, clinically significant emboli are rare and potentially fatal. The clinical sign of CO2 embolism depends on the volume of embolized gas and ranges from asymptomatic to cardiovascular collapse or even death. This article reviews the epidemiology, pathophysiology, clinical presentation, treatment, and prevention of CO2 embolisms.