Albertine K H, Wiener-Kronish J P, Koike K, Staub N C
J Appl Physiol Respir Environ Exerc Physiol. 1984 Nov;57(5):1360-8. doi: 10.1152/jappl.1984.57.5.1360.
We studied the ultrastructural damage caused by venous air embolization in anesthetized sheep by morphological techniques after monitoring hemodynamics and lymph dynamics. Lung lymph flow and protein flux increased during 1 and 4 h of venous air embolization, results consistent with increased microvascular permeability. Histologically, the air emboli were restricted to the small pulmonary arterial vessels (1,000 to 100 micron in diam). Neutrophils accumulated around the air bubbles and formed intravascular clumps. Ultrastructurally, at the air embolus-blood interface, neutrophils appeared attached to a layer a proteinaceous material. Many neutrophils were in close contact with the pulmonary arterial endothelial cells. We found gaps (0.1-3 micron in width) between the endothelial cells of the pulmonary arterial microvessels. Beneath these gaps the basal lamina was disrupted. Other vessel types were unaffected. Some lymphocytes were seen near the air bubbles and the endothelial cell gaps. Platelets remained discoid, and fibrin clots were not observed. These results indicate that venous air embolization in sheep damages the pulmonary arterial microvessels. Neutrophils are closely associated to both the air emboli and the endothelial cell gaps.
在监测血流动力学和淋巴动力学后，我们通过形态学技术研究了麻醉绵羊静脉空气栓塞所造成的超微结构损伤。在静脉空气栓塞的1小时和4小时期间，肺淋巴流量和蛋白质通量增加，结果与微血管通透性增加一致。组织学上，空气栓子局限于小的肺动脉血管（直径1000至100微米）。中性粒细胞在气泡周围聚集并形成血管内团块。超微结构上，在空气栓子 - 血液界面处，中性粒细胞似乎附着于一层蛋白质物质上。许多中性粒细胞与肺动脉内皮细胞紧密接触。我们发现肺动脉微血管内皮细胞之间存在间隙（宽度为0.1 - 3微米）。在这些间隙下方，基膜被破坏。其他血管类型未受影响。在气泡和内皮细胞间隙附近可见一些淋巴细胞。血小板保持盘状，未观察到纤维蛋白凝块。这些结果表明，绵羊静脉空气栓塞会损伤肺动脉微血管。中性粒细胞与空气栓子和内皮细胞间隙均密切相关。
