CO2-Emphysem bei laparoskopischer Chirurgie: Veränderungen der pulmonalen CO2-Elimination

We report on two patients with subcutaneous carbon dioxide (CO 2 ) emphysema that developed during laparoscopic surgery with CO 2 pneumoperitoneum (PP), in whom pulmonary elimination of CO 2 (ECO 2 , Servo ventilator with integrated CO 2 analyzer 930, Siemens) was continuously monitored. Patient 1 was a 61 -year-old man with laparoscopic herniotomy. ECO 2 immediately before PP was 120 ml/min × m 2 and increased rapidly after 45 min PP to a maximum value of 340 ml/min × m 2 . At that time, minute ventilation had been increased from 7 to 11 l/min and PaCO 2 had risen from 35 to 57 mm Hg. At the end of the procedure the patient showed excessive subcutaneous emphysema