Small change in capnography led to the detection of an intravascular thrombus

This report highlights the importance of accurate interpretation of even small intraoperative capnography changes. In this case, an otherwise unexplained sudden small decrease in end-expiratory carbon dioxide tension (P ETCO 2) led to the detection of a deep venous thrombus. During the surgery of a...

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Bibliographic Details
Published in:Journal of clinical anesthesia 2004-06, Vol.16 (4), p.286-288
Main Authors: Schmitt, Hubert J, Beckmann, Tim, Lang, Werner
Format: Article
Language:English
Subjects:
Adult
Airway management
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Blood clots
Blood pressure
Capnography
Carbon dioxide
Carbon Dioxide - analysis
Cardiac arrhythmia
deep venous thrombosis
Female
Heart rate
Humans
Hypotension
intraoperative
Intubation
Lung diseases
Lungs
Lymph Node Excision - adverse effects
Medical sciences
monitoring: dead space
Patients
Pulmonary embolisms
Surgeons
Surgery
Thromboembolism
Veins & arteries
Venous Thrombosis - diagnosis
Ventilators
Citations: Items that this one cites
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Summary:This report highlights the importance of accurate interpretation of even small intraoperative capnography changes. In this case, an otherwise unexplained sudden small decrease in end-expiratory carbon dioxide tension (P ETCO 2) led to the detection of a deep venous thrombus. During the surgery of a 34-year-old woman with a known carcinoma of the corpus uteri, who was scheduled for paraaortal lymphadenectomy, a sudden decrease in carbon dioxide tension occurred. In careful exploration of the surgical field to rule out a thromboembolic event, the surgeons noticed an induration of the right iliac vein. A consulting vascular surgeon exposed a right-sided, irregular, double-lumen, common iliac vein with a thrombus the tip of which floated in the inferior vena cava. Following complete thrombectomy, the procedure was accomplished without further adverse events.
ISSN:0952-8180
1873-4529
DOI:10.1016/j.jclinane.2003.07.013