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Causes of hypoxemia during laparoscopic and robotic surgery

Patient factors

Preexisting cardiopulmonary dysfunction
Morbid obesity

Intraoperative ventilation

Low FiO₂
Hypoventilation

V/Q mismatch

Endobronchial intubation
Atelectasis
Capno (pneumo) thorax
Pulmonary embolism
Patient position (eg, lateral decubitus)

Reduced cardiac output

Inferior vena cava compression
Dysrhythmias
Myocardial depression (eg, anesthetic drug effects)
Hemorrhage

Anemia

Pre-existing anemia
Hemorrhage

FiO₂: fraction of inspired oxygen; V/Q: ventilation/perfusion.

Adapted with permission from: Joshi G, Cunningham A. Anesthesia for laparoscopic and robotic surgeries. In: Clinical Anesthesia, 7th ed, Barash PG, Cullen BF, Stoelting RK, et al (Eds), Lippincott Williams & Wilkins, Philadelphia 2013. Copyright © 2013 Lippincott Williams & Wilkins. www.lww.com.

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