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Cardiovascular Research 1997 34(3):473-482; doi:10.1016/S0008-6363(97)00063-1
© 1997 by European Society of Cardiology
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Copyright © 1997, European Society of Cardiology

Cardiac depression after experimental air embolism in pigs: role of addition of a surface-active agent1

Jan Heim van Blankensteina,2, Cornelis J Slagerb,*, Lou Kie Soeia, H Boersmab, Th Stijnend, J.C.H Schuurbiersb, Rob Kramsa, B Lachmannc and Pieter D Verdouwa

aThoraxcenter, Erasmus University Rotterdam, Rotterdam, Netherlands
bThe Thoraxcenter, University Hospital Rotterdam-Dijkzigt, Rotterdam, Netherlands
cDepartment of Anesthesiology, Erasmus University Rotterdam, Rotterdam, Netherlands
dDepartment of Biostatistics, Erasmus University Rotterdam, Rotterdam, Netherlands

* Corresponding author. Laboratory for Haemodynamics, Thoraxcenter Ee 2322, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, Netherlands. Tel.: +31 (10) 4088044; fax: +31 (10) 4365191; e-mail: slager@tch.fgg.eur.nl

Objective: Air bubbles entering the coronary artery may have harmful effects on cardiac function. From the physical point of view it is the relatively high surface tension of the blood–air interface which causes bubbles to trap in small vessels. The aim of the present study was to reduce depression of myocardial function from air embolism by lowering the surface tension of air bubbles. Methods: The effect of using antifoam as a surface-tension-reducing agent on air bubble entrapment and cardiac function was investigated in 6 anesthetized pigs (27±1 kg) and analyzed using a two-compartment diffusion model. Air bubbles with a diameter of 150 µm were selectively injected into the left anterior descending coronary artery (LADCA) in a carrying fluid in the presence or absence of antifoam. Myocardial systolic segment shortening in the LADCA region (SS-LADCA) was measured by sonomicrometry. Presence of emboli was detected by measuring the amount of reverberation of ultrasound scattered by trapped air bubbles. Results: SS-LADCA transiently decreased after injections of air bubbles in both the absence and presence of antifoam. However, in the presence of antifoam the regional depression recovered to normal sooner, the average depth of the depression was reduced, and bubbles from the embolized area cleared faster. These observations can be explained by a model derived from Laplace's law.

KEYWORDS Coronary air embolism; Surface tension; Antifoam; Surfactant; Pig, anesthetized

1 Work performed at the Thoraxcenter, Erasmus University, Rotterdam.

2 Present address: Grabowsky Polytechnics BV, Mauritskade 33, 2514 HD Den Haag, Netherlands. Tel.: +31 (70) 3560976; fax: +31 (70) 3607959; e-mail: van.blankenstein@grabowsky.nl


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