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Cardiac Arrest in the Neonate During Laparoscopic Surgery
Anesthesia & Analgesia, 08/21/09

Lalwani K et al. – The authors describe a case of intraoperative neonatal cardiac arrest during attempted laparoscopic surgery. Circulatory collapse occurred before peritoneal insufflation, initially obscuring the diagnosis. Greater awareness of this complication in neonates will facilitate early diagnosis and encourage preventive measures, such as the avoidance of umbilical vessels, use of an open instead of closed access technique, and ligation of bleeding vessels after peritoneal access.

Exclusive Author Commentary
Kirk Lalwani, 08/23/09

Adding strength to this issue is a second case from a different institution that had to be removed from the final report as the outcome had not been as favorable and was likely proceeding to litigation. Neonates are, of course particularly vulnerable to this complication as a result of the patent ductus arteriosus and the patent foramen ovale that allow venous gas embolism to enter the systemic circulation and result in arterial gas embolic effects.

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