Ii. Serum Lipoprotein Pattern in Fat Embolism in the Dog

Abstract. Previous observations in these series of studies in dogs with femoral fractures showed that pulmonary fat emboli have a triglyceride fatty acid composition similar to bone marrow fat. The present study is concerned with the question as to whether the emboli are mechanically liberated from traumatized fat‐rich tissues or the result of increased mobilisation rate of free fatty acids, incorporated into triglycerides outside the adipose tissue. Variations in the fatty acid level caused by the administration of norepinephrine or nicotinic acid did not influence the number of pulmonary fat emboli, the amount of emboli triglycerides or their fatty acid composition. No significant correlations were observed between the plasma FFA level and the number or amount of pulmonary fat emboli. 14C‐labelled fatty acids bound to albumin were infused during the experiments in 3 dogs simultaneously infused with norepinephrine. These fatty acids were not incorporated in the fat emboli. These observations indicate that fat embolisation after fractures in dogs is due to a mechanical liberation of bone marrow fat and not to the rise in the rate of fatty acid mobilisation from the adipose tissue induced by the trauma.

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The role of methylmethacrylate monomer in the formation and haemodynamic outcome of pulmonary fat emboli

Elmaraghy¹,

Humeniuk²,

Anderson³

et al. 1998

The Journal of Bone and Joint Surgery

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We examined the roles of methylmethacrylate (MMA) monomer and cementing technique in the formation, and haemodynamic outcome, of pulmonary fat emboli. The preparation of the femoral canal and the cementing technique were studied in four groups of adult dogs as follows: control (no preparation); lavage; cement pressurisation; and cement pressurisation after lavage. We measured the intramedullary pressure, pulmonary artery pressure (PAP), pulmonary capillary wedge pressure and bilateral femoral vein levels of triglyceride, cholesterol and MMA monomer at rest and after reaming, lavage, and cementing. Femoral vein triglyceride and cholesterol levels did not vary significantly from resting levels despite significant elevations in intramedullary pressure with reaming, lavage and cementing (p = 0.001). PAP was seen to rise significantly with reaming (p = 0.0038), lavage (p = 0.0031), cementing (p = 0.0024) and cementing after lavage (p = 0.0028) while the pulmonary capillary wedge pressure remained unchanged. MMA monomer was detected in femoral vein samples when cement pressurisation was used. Intramedullary lavage before cementing had no significant effect on the MMA level. Haemodynamic evidence of pulmonary embolism was noted with reaming and intramedullary canal preparation, irrespective of the presence of MMA monomer. We found no relationship between MMA monomer level and intramedullary pressure, PAP or pulmonary capillary wedge pressure. Our findings suggest that the presence of MMA monomer in femoral venous blood has no effect on the formation of fat emboli or their pulmonary haemodynamic outcome during cemented hip arthroplasty.

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Ii. Serum Lipoprotein Pattern in Fat Embolism in the Dog

Cited by 4 publications

References 7 publications

Pathogenesis of post-traumatic fat embolism

Pathogenesis of post-traumatic fat embolism

Vi. The Influence of Increased and Decreased Plasma Free Fatty Acids on the Formation and Composition of the Fat Emboli in the Dog

The role of methylmethacrylate monomer in the formation and haemodynamic outcome of pulmonary fat emboli

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