(10) Venous C0₂ embolism

End-tidal C0₂ monitoring is essential during laparoscopy, as it may help in the early detection of venous C0₂ embolism (accidental insufflation of C0₂ into the veins). In addition, C0₂ is also absorbed from abdominal cavity. A transient but rapid rise in PETCO₂, has been suggested as a useful early sign of venous C0₂ embolism.¹ However, when CO₂ embolus increases in size and thereby producing a mechanical obstruction, end-tidal CO₂ decreases as can be seen from the following animation.

Reference:

1. Shulman D, Aronsons HB. Capnography in the early diagnosis of carbon dioxide embolism. Can Anaesth Soc J 1984;31:455-9.