The OR was trialling a new insufflation system and the vendor representative was out of the room taking a phone call.The perioperative nurse was concerned that the flow rate was well above 14 L/min and the pressure had risen to 16 mm Hg.She alerted the surgeon and reduced the rate and pressure because she feared that the elderly patient was at high risk for:

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Overpressurization can be extremely hazardous to the patient.Excess pressure can force CO₂ to diffuse into the blood,resulting in hypercarbia.End-tidal CO₂ monitoring becomes a crucial assessment parameter to detect increased CO₂ absorption.Excess pressure also increases diaphragmatic pressure,which can cause gastric regurgitation and aspiration of stomach contents.It also can reduce intrathoracic space,resulting in decreased respiratory effort and cardiac output.The phrenic nerve innervates the diaphragm and is responsible for some motor activity associated with respiration.CO₂ gas can irritate this nerve,causing postoperative pain in the shoulder and neck.Excessive pressure could cause tremendous postoperative discomfort and severe nerve damage.

The OR Was Trialling a New Insufflation System and the Vendor