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Departments of 1 Medicine,
2 Anesthesiology, and
3 Physiology and Biophysics,
The distribution of gaseous pulmonary emboli is presumed to be determined by their buoyancy. We hypothesized that regional pulmonary blood flow may also influence their distribution. Therefore, pulmonary blood flow was measured in supine, anesthetized dogs with use of 15-µm fluorescent microspheres at baseline and during N2 embolism. The animals were killed, and the lungs were excised, air-dried, and diced into ~2-cm3 pieces with weights and spatial coordinates recorded. Embolism was defined as a >10% flow decrease relative to baseline. Vertically, the incidence of embolism increased substantially by 6 ± 1% per additional centimeter in height compared with baseline (P = 0.0003). Embolism also increased radially by 3 ± 1%/cm from the hilum (P = 0.002). There was a weaker but statistically significant increase in embolism to pieces with greater baseline flow, 9 ± 2% for every 1.0 increase in relative baseline flow (P = 0.008). We conclude that the distribution of gaseous emboli is influenced by buoyancy and flow dynamics within the pulmonary vasculature.
fluorescent microspheres; air embolism; pulmonary gas exchange; pulmonary circulation; decompression illness
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