{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:49:34Z","timestamp":1759970974455,"version":"build-2065373602"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T00:00:00Z","timestamp":1651708800000},"content-version":"vor","delay-in-days":124,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia Reports"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>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\u2010tidal carbon dioxide. Using a high carbon dioxide insufflation pressure in the retroperitoneal space enhances visualisation of the surgical field by decreasing small\u2010calibre 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\u2010operative surgical challenges can assist with the detection of this rare but potentially fatal complication.<\/jats:p>","DOI":"10.1002\/anr3.12164","type":"journal-article","created":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T00:14:29Z","timestamp":1651796069000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Carbon dioxide embolism during posterior retroperitoneal adrenalectomy"],"prefix":"10.1002","volume":"10","author":[{"given":"M.","family":"Alexeev","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Saint\u2010Petersburg State University Hospital  St. Petersburg Russian Federation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Fedorov","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Saint\u2010Petersburg State University Hospital  St. Petersburg Russian Federation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Kuleshov","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Saint\u2010Petersburg State University Hospital  St. Petersburg Russian Federation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Rebrova","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Saint\u2010Petersburg State University Hospital  St. Petersburg Russian Federation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Efremov","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Saint\u2010Petersburg State University Hospital  St. Petersburg Russian Federation"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,5]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1067\/j.cpsurg.2013.12.001"},{"key":"e_1_2_5_3_1","first-page":"918346","article-title":"Systematic review of surgical approaches for adrenal tumors: lateral transperitoneal versus posterior retroperitoneal and laparoscopic versus robotic adrenalectomy","author":"Chai YJ","year":"2014","journal-title":"International Journal of Endocrinology"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2006.07.039"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2017-219397"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199604000-00026"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-1498"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2018.10.008"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2017.10.073"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yasu.2009.02.017"},{"key":"e_1_2_5_11_1","first-page":"483","article-title":"Diagnosis and treatment of air embolism","volume":"4","author":"Moszy\u0144ski K","year":"1970","journal-title":"Neurologia i Neurochirurgia Polska"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2012.53.3.459"}],"container-title":["Anaesthesia Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.12164","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/anr3.12164","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.12164","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T11:50:59Z","timestamp":1759924259000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1002\/anr3.12164"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1002\/anr3.12164"],"URL":"https:\/\/doi.org\/10.1002\/anr3.12164","archive":["Portico"],"relation":{},"ISSN":["2637-3726","2637-3726"],"issn-type":[{"type":"print","value":"2637-3726"},{"type":"electronic","value":"2637-3726"}],"subject":[],"published":{"date-parts":[[2022,1]]},"assertion":[{"value":"2022-04-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e12164"}}