Intraoperative Hypercapnia and Respiratory Acidosis During Robotic Paraesophageal Hernia Repair

Authors

• Doha Amin
• Vivian Chang, Corewell Health East Resident
• Nasim Shakibai, Corewell Health East Resident
• Roy Soto, Corewell Health East

Document Type

Conference Proceeding

Publication Date

10-18-2026

Abstract

Elevated carbon dioxide levels during mediastinal surgery present unique challenges due to changes in ventilation and limited pulmonary reserve. We report a 73-year-old woman with hypertension undergoing elective robotic paraesophageal hernia repair. Intraoperatively, she developed progressive hypercapnia and severe respiratory acidosis despite aggressive ventilatory adjustments. The etiology was excessive carbon dioxide insufflation with mediastinal tracking, supported by subcutaneous emphysema and markedly abnormal arterial blood gases. After reducing insufflation, gas exchange improved. She was admitted postoperatively for monitoring. This case highlights early recognition of hypercapnia, vigilance for severe physiologic derangements, and coordinated intraoperative management during mediastinal surgery.

Comments

American Society of Anesthesiologists, The Anesthesiology Meeting, October 16-20, 2026, San Diego, CA

Recommended Citation

Amin D, Chang V, Shakibai N, Soto R. Intraoperative hypercapnia and respiratory acidosis during robotic paraesophageal hernia repair. Presented at: American Society of Anesthesiologists, The Anesthesiology Meeting; 2026 Oct 18; San Diego, CA. Available from: https://www.abstractsonline.com/pp8/#!/21448/presentation/7461