It was long been thought that emboli are buoyant and therefore would move in an anti-gravity direction. Therefore sitting or lying with raised head would potentially encourage migration into the brain which is why the head-down position has been advised as a good precaution38. However, the buoyancy of gas bubbles is not sufficient to counteract advancement by blood flow, so placing the patient head-down is not very helpful. Moreover, the head-down position may aggravate the cerebral oedema that develops in these patients. So, the current recommendation is to place these patients in a flat supine position41.
In the same way, the left lateral position has an effect of trapping venous bubbles in the tip of the right ventricle, removing the obstruction of the ejection chamber42,43. - Hemodynamic condition of patient
A decrease in arterial blood pressure would compound the blocking and pro-ischemic effects of bubbles; hypotension is an additional risk factor for
Similarly, hypovolemia increases the relative proportion of the volume of embolized gas.
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