Effects of Aprotinin on Pulmonary Functions in Experimental Fat Embolism: Changes in Arterial Blood Gas Levels and Scintigraphic Findings

Abstract

Purpose: To assess the effects of aprotinin on the formation and resolution of fat embolism of the lungs. Methods: The changes in arterial blood gas levels and perfusion scintigraphy were studied by forming experimental standardized fat embolism in rabbits with autogenous fat obtained from their femur medullas. Two groups, each consisting of 14 albino rabbits, were used in this study. Group 1, which received intravenous saline solution, was the control group. Group 2, which received aprotinin, was referred to as the aprotinin group. Autogenous femoral medullary content was used for embolization procedures. Arterial blood gas levels were recorded 72 hours before and 1, 24, 72 hours and 10 days following the embolization procedure. Pulmonary perfusion scintigraphies were performed 72 hours before the embolization procedure and on the first and 72nd hours, and the 10th day. Results: Fat embolism was achieved in all rabbits. Seven rabbits in the control group and one rabbit in the aprotinin group died within an hour after the embolization procedure. According to blood gas levels and perfusion scintigraphic findings, the aprotinin group significantly had less pulmonary fat embolism and recovered faster than the control group, especially during the first 24 hours. There was no significant difference in regression of pulmonary dysfunction between the two groups. Conclusion: The correlation between the blood gas levels and scintigraphic findings suggested that the administration of aprotinin for prophylactic purposes had favorable effects on the development of pulmonary gas exchange disturbance and perfusion defect in fat embolism.

Modern approaches in experimental modeling of fat embolism (literature review)

“…Hausberger (1991) после внутривенного введения нейтрального жира у крыс, декапитированных через 12, 24 и 48 ча-сов, 86 % липидов было сконцентрировано в легких. На данной модели изучали эффективность искусствен-ной вентиляции, регуляцию дыхания и легочное крово-обращение при эмболическом отеке легких [10,[17][18][19][20][21][22].…”

“…В экспери-ментах оценивали гидростатическое давление, ско-рость кровотока в легких и системное АД [19,22,23].…”

“…Выявлено, что неотложно выполненный интрамедуллярный остеосинтез больше усиливает ин-травазацию ЖГ, чем накостный способ, особенно при гиповолемии. При отсроченном остеосинтезе метод фиксации не влиял на степень ЖГ [10,22].…”