Possible venous air embolism during open eye surgery in a child.
OBJECTIVE
Although venous air embolism is a well recognized complication within most surgical subspecialties, it has only been reported recently during eye surgery in one adult, and never before in a child. We describe the case of a 17-month-old boy who sustained a possible air embolism during repair of an open trauma of his right eye.


METHODS
A vitrectomy through the pars plana with air-fluid exchange of the posterior chamber was performed under general anesthesia to remove a foreign body which had impaled the optic nerve. A few minutes after removal of the foreign body, a notable decrease in end-tidal CO(2), oxygen saturation and arterial blood pressure occurred, requiring administration of a high inspired oxygen fraction and vasopressors. Venous air embolism was strongly suspected after other causes of a decrease of end-tidal CO(2) and hypoxemia had been excluded. An arterial blood gas confirmed hypoxemia and respiratory acidosis.


CONCLUSIONS
Although venous air embolism is a rare complication of eye surgery, it should nevertheless be considered as a possible complication during air-fluid exchange vitrectomy in children.
Ruest
Pierre
P
Department of Anesthesiology, Centre hospitalier universitaire Sainte-Justine, 3175 Cote Sainte-Catherine Road, Montreal, Quebec H3T 1C5, Canada. pierre.ruest.hsj@ssss.gouv.qc.ca
Aroichane
Maryam
M
Cordahi
Ghassan
G
Bureau
Nathalie
N
D000142:Acidosis, Respiratory / Q000209:etiology; D001784:Blood Gas Analysis; D004618:Embolism, Air / Q000209:etiology*; D005547:Foreign Bodies / Q000601:surgery*; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D007223:Infant; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D020221:Optic Nerve Injuries / Q000601:surgery; D014821:Vitrectomy / Q000009:adverse effects*