Effects of pulmonary gas embolism on circulation and respiration in the dog

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Abstract
Intravenous injection of gas (10–60 ml) causes acute pulmonary embolism, which disappears completely within 10–20 min. Intravenous infusion of gas (1–5 ml min−1) can be continued for a long time. During these infusions a steady state is reached in which pulmonary arterial pressure is increased and cardiac output remains unaltered. This indicates that the degree of embolization has reached a constant level despite the continuous gas infusion. These findings can be explained by a gradual disappearance of the bubbles from the pulmonary circulation. The purpose of this study was to measure the possible excretion of gas from the intravascular gas bubbles into the alveolar air after venous administration. Neon was used as a test gas since its fractional concentration in ambient air is low (0.00018) and it can be detected by gas chromatography with sufficient accuracy. It could be demonstrated that after injection neon was present in the expiration gas. During the steady state of infusion the rate of excretion in the expiration gas appeared to be equal to the rate of infusion. Changes in the pulmonary arterial pressure curve were reflected in the neon wash-out curve. It may be concluded that during pulmonary gas embolism the administered gas is excreted into the alveolar air and that the excretion rate largely depends on the increased pulmonary arterial pressure due to the obstructing bubbles themselves.