Document Detail

Estimate of the maximum absorption rate of microscopic arterial air emboli after entry into the arterial circulation during cardiac surgery.
MedLine Citation:
PMID:  8971944     Owner:  NLM     Status:  MEDLINE    
Some clinicians place patients in the Trendelenburg position during aortic unclamping to decrease the incidence of microscopic cerebral air embolism. Experimental studies have shown that use of the Trendelenburg position does not prevent air emboli from reaching the brain. Nevertheless, the position can decrease the velocity at which bubbles approach the brain, giving more time for nitrogen in the bubbles to be absorbed. We applied a validated mathematical model to estimate that the maximum rate of absorption of microscopic air emboli in blood during and after cardiopulmonary bypass (CPB) equals 1.57 microns/s. This rate is very small, since clinically relevant microbubbles have radii 50-1500 microns, and travel from the aorta to the brain within seconds. The result holds for all usual conditions of CPB. We conclude that absorption does not affect the disposition of air introduced into the arterial circulation. Use of the Trendelenburg position cannot decrease neurologic injury from cerebral air embolism by permitting greater bubble absorption.
F Dexter; B J Hindman; J S Marshall
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Perfusion     Volume:  11     ISSN:  0267-6591     ISO Abbreviation:  Perfusion     Publication Date:  1996 Nov 
Date Detail:
Created Date:  1997-03-19     Completed Date:  1997-03-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8700166     Medline TA:  Perfusion     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  445-50     Citation Subset:  IM    
Department of Anesthesia, University of Iowa, Iowa City 52242, USA.
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MeSH Terms
Cardiac Surgical Procedures / adverse effects*
Cerebrovascular Circulation
Embolism, Air
Intracranial Embolism and Thrombosis / etiology,  physiopathology*
Models, Theoretical*

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