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Query: UMLS:C0020440 (hypercapnia)
 7,939 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Carbon dioxide accumulation under ophthalmic drapes is caused by their impaired permeability to exhaled carbon dioxide in spontaneously breathing patients. Three different ophthalmic drapes were examined under clinical conditions. Sixty unpremedicated patients of each gender, aged over 60 years and with an ASA status of I-III undergoing cataract surgery under retrobulbar anaesthesia were included in the study. Patients with known pulmonary diseases were excluded. The patients were divided into three groups of 20 patients each. In all groups, oxygen was insufflated under the drapes at a constant flow of 21.min-1. Carbon dioxide concentration in the inspired air, transcutaneous carbon dioxide pressures, respiratory rate and oxygen saturation by pulse oximetry were measured. Accumulation of carbon dioxide under the drapes, increase of partial pressure of transcutaneous carbon dioxide and hyperventilation were observed in all three groups. An oxygen supply of 21.min-1 prevented hypoxaemia but not hypercapnia. Therefore, producers of ophthalmic drapes are encouraged to look for further ways to increase the carbon dioxide permeability of their drapes with the aim of reducing carbon dioxide accumulation and hyperventilation in spontaneously breathing patients undergoing eye surgery.
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PMID:Accumulation of carbon dioxide under ophthalmic drapes during eye surgery: a comparison of three different drapes. 1071 83

ASA closed claims from 2000 to 2009 have shown that adverse respiratory events are more common in nonoperating room locations like endoscopy suite than in the operating room (44% v/s 20%). Here, we report a case of lung atelectasis which resulted in hypoxemia in a malnourished patient undergoing endoscopic procedure. It is crucial to identify the high-risk patients and monitor them appropriately in the postoperative phase. Continuous capnometry may offer additional benefit by identifying hypercapnia, hypoventilation at the earliest in the recovery area, thus preventing serious complications.
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PMID:Left Lower Lung Collapse in a Patient Undergoing Endoscopic Procedure. 3208 38

This case report discusses an unlikely occurrence of massive subcutaneous emphysema in an elective robotic-assisted laparoscopic total hysterectomy in a 45-year-old, ASA class 1 woman. The patient's perioperative course was otherwise uncomplicated, with the subcutaneous emphysema developing at surgical closure. The patient presented with substantial crepitus spanning from her face to her lower extremities and hypercarbia with end-tidal carbon dioxide readings persistent between 60 and 70 mm Hg. This case did not result in clinically significant airway obstruction because of provider vigilance. However, undiagnosed subcutaneous emphysema without a secured airway may lead to respiratory distress, respiratory depression, airway obstruction, tracheal deviation, and tension pneumothorax.
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PMID:Recognition and Management of Subcutaneous Emphysema as a Complication of Robotic-Assisted Laparoscopic Surgery: A Case Report. 3223 4


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