CO2– Gasembolie nach akzidenteller Gefäßpunktion bei laparoskopischer Cholezystektomie

We report a case of carbon dioxide (CO(2)) embolism in a 52-year-old man during a laparoscopic cholecystectomy, which caused an accidental CO(2)-insufflation in a vessel despite exact control of the Verres needle. The first manifestations were two drops of the partial pressure of endtidal carbon dioxide (Petco(2)) from 34 mmHg to 13 mmHg and again from 37 mmHg to 11 mmHg, followed by pulseless ventricular tachycardia. It was possible to achieve resuscitation and a recompensation of the right heart failure with drug therapy. After successful resuscitation and restoration of a stable hemodynamic situation, an abrupt increase in the Petco(2) from 11 mmHg to 52 mmHg was noted. This increase of Petco(2) could be interpreted as the reinstallation of circulation and the amount of CO(2) in the organism after carbon dioxide embolism.