Carbon dioxide embolism during posterior retroperitoneal adrenalectomy

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Carbon dioxide embolism during posterior retroperitoneal adrenalectomy. / Alexeev, M.; Fedorov, E.; Kuleshov, O.; Rebrova, D.; Efremov, S.

In: Anesthesia Reports, Vol. 10, No. 1, e12164, 17.05.2022.

Research output: Contribution to journal › Article › peer-review

BibTeX

@article{52de86d4f9544d33993072c25d8a0e11,

title = "Carbon dioxide embolism during posterior retroperitoneal adrenalectomy",

abstract = "We report a case of massive carbon dioxide embolism associated with injury to the inferior vena cava, during posterior retroperitoneoscopic adrenalectomy. The presenting clinical features were tachycardia, rapid oxygen desaturation and severe respiratory acidosis, without evidence of bleeding. The patient was resuscitated by increasing the fraction of inspired oxygen, administering intravenous fluid and converting to an open procedure to suture the vein. This case demonstrates that gas embolism due to vessel injury during posterior retroperitoneal adrenalectomy may arise without evidence of bleeding, severe hypotension or an abrupt increase in end-tidal carbon dioxide. Using a high carbon dioxide insufflation pressure in the retroperitoneal space enhances visualisation of the surgical field by decreasing small-calibre vessel bleeding. However, it can contribute to, and delay recognition of, carbon dioxide embolism. Knowledge of the clinical features of carbon dioxide embolism, careful monitoring and vigilance for intra-operative surgical challenges can assist with the detection of this rare but potentially fatal complication.",

keywords = "adrenalectomy, anaesthesiology, carbon dioxide, embolism, air, laparoscopy",

author = "M. Alexeev and E. Fedorov and O. Kuleshov and D. Rebrova and S. Efremov",

note = "{\textcopyright} 2022 Association of Anaesthetists.",

year = "2022",

month = may,

day = "17",

doi = "10.1002/anr3.12164",

language = "English",

volume = "10",

journal = "Anaesthesia Reports",

issn = "2637-3726",

publisher = "Wiley-Blackwell",

number = "1",

}

RIS

TY - JOUR

T1 - Carbon dioxide embolism during posterior retroperitoneal adrenalectomy

AU - Alexeev, M.

AU - Fedorov, E.

AU - Kuleshov, O.

AU - Rebrova, D.

AU - Efremov, S.

PY - 2022/5/17

Y1 - 2022/5/17

N2 - We report a case of massive carbon dioxide embolism associated with injury to the inferior vena cava, during posterior retroperitoneoscopic adrenalectomy. The presenting clinical features were tachycardia, rapid oxygen desaturation and severe respiratory acidosis, without evidence of bleeding. The patient was resuscitated by increasing the fraction of inspired oxygen, administering intravenous fluid and converting to an open procedure to suture the vein. This case demonstrates that gas embolism due to vessel injury during posterior retroperitoneal adrenalectomy may arise without evidence of bleeding, severe hypotension or an abrupt increase in end-tidal carbon dioxide. Using a high carbon dioxide insufflation pressure in the retroperitoneal space enhances visualisation of the surgical field by decreasing small-calibre vessel bleeding. However, it can contribute to, and delay recognition of, carbon dioxide embolism. Knowledge of the clinical features of carbon dioxide embolism, careful monitoring and vigilance for intra-operative surgical challenges can assist with the detection of this rare but potentially fatal complication.

AB - We report a case of massive carbon dioxide embolism associated with injury to the inferior vena cava, during posterior retroperitoneoscopic adrenalectomy. The presenting clinical features were tachycardia, rapid oxygen desaturation and severe respiratory acidosis, without evidence of bleeding. The patient was resuscitated by increasing the fraction of inspired oxygen, administering intravenous fluid and converting to an open procedure to suture the vein. This case demonstrates that gas embolism due to vessel injury during posterior retroperitoneal adrenalectomy may arise without evidence of bleeding, severe hypotension or an abrupt increase in end-tidal carbon dioxide. Using a high carbon dioxide insufflation pressure in the retroperitoneal space enhances visualisation of the surgical field by decreasing small-calibre vessel bleeding. However, it can contribute to, and delay recognition of, carbon dioxide embolism. Knowledge of the clinical features of carbon dioxide embolism, careful monitoring and vigilance for intra-operative surgical challenges can assist with the detection of this rare but potentially fatal complication.

KW - adrenalectomy

KW - anaesthesiology

KW - carbon dioxide

KW - embolism, air

KW - laparoscopy

UR - http://www.scopus.com/inward/record.url?scp=85134721749&partnerID=8YFLogxK

UR - https://www.mendeley.com/catalogue/b66f6d2b-b993-3ad3-8fd4-ecf67ed09372/

U2 - 10.1002/anr3.12164

DO - 10.1002/anr3.12164

M3 - Article

C2 - 35572617

AN - SCOPUS:85134721749

VL - 10

JO - Anaesthesia Reports

JF - Anaesthesia Reports

SN - 2637-3726

IS - 1

M1 - e12164

ER -

ID: 98504326