Air embolism with positive-pressure ventilation of rats

Although air embolism is known to occur in humans and animals when the lung is overdistended, very few cases have been reported to be associated with positive-pressure ventilation. We have observed that air embolism occurs in rats ventilated with high inspiratory pressures (70 cmH2O) associated with high end-expiratory pressures (10 cmH2O). However, it does not occur in normal rats if the end-expiratory pressure is less than 5 cmH2O or the peak inspiratory pressure is below 60 cmH2O when the frequency of ventilation is 30. Hemorrhagic shock predisposes to air embolism, whereas conditions with pulmonary edema (fluid overloading, lung injury from ventilation with high inspiratory and low expiratory pressures, or oxygen toxicity) decrease the probability of its occurrence.