Carbon dioxide insufflation technique as a potential cause a hemodynamic collapse in a patient without cardiovascular risk factors: A case report

Intrathoracic carbon dioxide (CO₂) insufflation improves surgical field visibility during robot-assisted thoracoscopic surgery but can induce hemodynamic instability. We report a 53-year-old man without cardiovascular risk factors who developed abrupt hemodynamic collapse, which was ameliorated by the cessation of insufflation. The surgery was completed uneventfully without further complications. This case demonstrates that CO₂ insufflation, although generally recommended, can cause life-threatening hemodynamic collapse without electrocardiographic changes. This highlites the importance of vigilant invasive monitoring at the start of insufflation and the immediate cessation of insufflation at the first sign of compromise, regardless of cardiovascular history.