Systemic air embolism in experimental penetrating lung injuries

Several reports have described systemic air embolism in association with penetrating lung injuries. We produce lung lacerations in 18 dogs ventilated with air containing charcoal powder. An ultrasonic bubble detector was positioned over the carotid artery in six dogs. Evidence of arterial air embolism was found in every case of pulmonary laceration in open-chest, tension pneumothorax, and hypovolemic preparations. The quantity of air was small, producing only transient arrhythmia. No air was detected under control conditions. We conclude that systemic air embolism is a frequent accompaniment of penetrating lung injuries, that it is rarely recognized clinically because of its generally small quantity and minor, nonspecific effects, but that the potential for dangerous air embolism does exist with lung wounds and warrants precautions in management.