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Ann Thorac Surg 1988;45:198-202
© 1988 The Society of Thoracic Surgeons

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Articles

Effect of the Trendelenburg Position on the Distribution of Arterial Air Emboli in Dogs

From the Department of Anesthesiology, University of Texas Medical School, Houston, and the Department of Surgery, University of Texas Medical Branch, Galveston, TX

Accepted for publication September 28, 1987.

^* Address reprint requests to Dr. Butler, Department of Anesthesiology, University of Texas Medical School, 6431 Fannin, 5.020 MSMB, Houston, TX 77030

We examined the effects of buoyancy on the distribution of arterial gas bubbles using in vitro and in vivo techniques in dogs. A simulated carotid artery preparation was used to determine the effects of bubble size and vessel angle on the velocity and direction of bubble movement in flowing blood. Because buoyancy tends to float bubbles away from dependent areas, bubble velocity would be expected to decrease as the vessel angle increased. We found that larger bubbles increased in velocity in the same direction as the blood flow at 0-, 10-, and 30-degree vessel angles and decreased when the vessel was positioned at 90 degrees. Smaller bubbles did not change velocity from 0 to 30 degrees and increased in velocity in the same direction as blood flow at 90 degrees. In 10 anesthetized dogs, we studied the effects of 0-, 10-, 15-, and 30-degree Trendelenburg's position on carotid artery distribution of gas bubbles injected into the left ventricle or ascending aorta. Regardless of the degree of the Trendelenburg position, the bubbles passed into the carotid artery simultaneously with passage into the abdominal aorta. We conclude that the forces of buoyancy do not overcome the force of arterial blood flow and that the Trendelenburg position does not prevent arterial bubbles from reaching the brain.

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