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ABSITE REVIEW QUESTIONS: CO2 EMBOLUS

ABSITE REVIEW QUESTIONS: CO2 EMBOLUS

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QUESTION: A 35 year old woman undergoing routine laparoscopic bilateral tubal ligation develops severe hypotension, tachycardia, and drop in her end tidal CO2. The anesthesiologist states the patient still has bilateral breath sounds. What is the most likely diagnosis?

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ANSWER:

– The most likely diagnosis in this patient is CO2 embolism.

– End tidal CO2 specifically reflects the exchange of CO2 from blood to the alveolus.

– A gradual rise in ETCO2 usually reflects impaired exchange from lung collapse or atelectasis.

– A sudden drop in ETCO2 can be from something simple like disconnection from the ventilator or something more serious such as an embolus.

– The abrupt drop in ETCO2 following an embolus is from the interruption of CO2 exchange at the alveolar level.

– Because of the hypotension associated with a drop in ETCO2 in the above patient, the most likely diagnosis is CO2 embolism.

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ABSITE BOOKS:

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ABSITE REVIEW QUESTIONS: BASIC SCIENCE (ABSITE 2014)

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HIGH YIELD ABSITE REVIEW (ABSITE 2014)

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