This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Google Scholar Articles by Lalwani, K. Articles by Aliason, I. PubMed PubMed Citation Articles by Lalwani, K. Articles by Aliason, I.

---

PEDIATRIC ANESTHESIOLOGY

Cardiac Arrest in the Neonate During Laparoscopic Surgery

From the Departments of Anesthesiology and Perioperative Medicine, and Pediatrics, Oregon Health and Science University, Portland, Oregon.

Address correspondence to Kirk Lalwani, MD, FRCA, MCR, Anesthesiology and Perioperative Medicine, BTE-2, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239. Address e-mail to lalwanik{at}ohsu.edu.

Abstract

We describe a case of intraoperative neonatal cardiac arrest during attempted laparoscopic surgery. Circulatory collapse occurred before peritoneal insufflation, initially obscuring the diagnosis. Emergent transthoracic echocardiography during resuscitation demonstrated intracardiac gas bubbles consistent with venous gas embolism. The site of entrainment was probably a bleeding umbilical vein transected by the umbilical trocar. Greater awareness of this complication in neonates will facilitate early diagnosis and encourage preventive measures, such as the avoidance of umbilical vessels, use of an open instead of closed access technique, and ligation of bleeding vessels after peritoneal access.