Waldo W J, Harlaftis N N, Symbas P N
J Thorac Cardiovasc Surg. 1976 Jan;71(1):96-101.
Systemic arterial air embolization following penetrating injury of the lung has been previously reported. As we had not recognized this complication clinically, we studied this problem in 11 healthy dogs. In each of them, a mock circulation was created by establishing two central external arteriovenous shunts with transparent plastic tubing in which air bubbles could be seen. Also, a Doppler flow detector capable of sensing intravascular air was attached to a carotid artery. Systemic arterial and pulmonary capillary wedge pressures were recorded, and a standard lung laceration was produced. In 5 of the dogs, in addition, tension pneumothorax was induced by injection of air into the pleural space. The dogs were monitored for intravascular air for 15 minutes before and after the induction of hypotension by withdrawal of blood from the shunts. In no animal was air seen in the shunts, nor was there the characteristic deflection of the Doppler seen with intravascular air, although the preparation was sensitive to the detection of as little as 1 ml. of air injected into the left atrium. These observations lead us to question whether arterial air embolism occurs with penetrating pulmonary trauma in man.
肺穿透伤后发生系统性动脉空气栓塞此前已有报道。由于我们在临床上尚未认识到这一并发症，因此我们在11只健康犬身上研究了这个问题。在每只犬身上，通过用透明塑料管建立两个中心体外动静脉分流来模拟循环，在分流中可以看到气泡。此外，将一个能够检测血管内空气的多普勒血流探测器连接到颈动脉上。记录系统性动脉压和肺毛细血管楔压，并造成标准的肺裂伤。另外，在5只犬中，通过向胸腔内注入空气诱发张力性气胸。在通过从分流中抽血诱发低血压之前和之后，对犬进行15分钟的血管内空气监测。尽管该装置对检测注入左心房低至1毫升的空气很敏感，但在任何动物的分流中均未见到空气，也未见到血管内空气时多普勒出现的特征性偏转。这些观察结果使我们质疑人类穿透性肺损伤时是否会发生动脉空气栓塞。
