Paradoxical air embolism in pigs with a patent foramen ovale

Recent studies have indicated that divers with a patent foramen ovale (PFO) are at risk of developing some forms of decompression sickness. Thus, the objective of the present study was to investigate if the occurrence of paradoxical air embolism (PAE) was enhanced in pigs with a PFO compared to the occurrence in pigs without such a defect. Out of 54 pigs, 18 had a PFO (group PFO), and the other 36 composed the controls (group C). The pigs were anesthetized, mechanically ventilated, and received venous air infusion at four different rates (0.050, 0.075, 0.100, and 0.200 ml.kg-1.min-1). PAE was monitored by use of a transesophageal echocardiographic probe to detect if any arterial air bubbles were present in the left atrium or the aorta. We found that PAE appeared at a lower infusion rate in group PFO than in group C. When PAE occurred, the mean pulmonary arterial pressure and the mean arterial pressure were significantly higher in pigs with a PFO than in the control pigs. Finally, the infused air volume per kilogram of body weight in group PFO was significantly lower than that observed in group C. The results demonstrated that the risk of PAE occurring in mechanically ventilated pigs with a PFO was greater compared to the risk observed in pigs without a PFO.