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*Department of Anaesthesiology and Intensive Care Medicine, University Hospital Kiel; and
Eye Hospital Bellevue, Kiel, Germany
Address correspondence and reprint requests to Thomas Ledowski, MD, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, D24105 Kiel, Germany. Address e-mail to ledowski{at}anaesthesie.uni-kiel.de.
We report a case of possible air embolism during a three-port pars plana vitrectomy and air-fluid exchange of the vitreous cavity of the eye. After the start of intraocular air flushing, sudden tachycardia, a decrease in oxygen saturation and end-tidal carbon dioxide tension, and a distinct "mill-wheel" murmur were observed. Venous air embolism was suspected but other sources of air entry into the circulation and a thromboembolic event were excluded. Once intraocular air flushing was ceased, clinical variables returned to normal within minutes. In conclusion, during air-fluid exchange of the vitreous cavity, air embolism should be considered as a possible rare complication.
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