Experimental fat embolism: A dynamic assessment of pulmonary fat-handling characteristics

Abstract

Injection 125I-glyceryl trioleate (0-5 mg/kg) into the right atrium of anaesthetized greyhounds caused the following changes: sequestration of far in the right side of the heart; 95 per cent removal by the lungs in a single passage through the pulmonary circulation; subsequent release of fat into the systemic circulation; rapid overall turnover of fat trapped in the lungs and slow removal of recirculating fat by other tissues. We believe that if there is release of unemulsified fat into the circulation in traumatic fat embolism these findings are of significance in interpreting the subsequent pulmonary events.

Cardiorespiratory effects of venous lipid micro embolization in an experimental model of mediastinal shed blood reinfusion

“…The finding that infusing lipid material on the venous side leads to negative hemodynamic consequences is not new. The phenomenon has been studied extensively in studies addressing adult respiratory distress syndrome and lipid embolization in orthopedic trauma [ 15 , 16 , 21 - 24 ]. All these studies, however, used models of macro-embolization, where the infused lipid was normally a single bolus of pure triolein, thus forming one or more large particles.…”

“…After the period of induced increase in cardiac output, radioactivity levels increased significantly, and thus some of the trapped emboli must have been forced out of the lungs. Sikorski et al concluded that 95% of triolein infused as macro-emboli was trapped in the lungs [ 15 ]. Our findings suggest that a high proportion of micro-emboli will also be trapped in the lungs.…”

“…Several groups have studied the pathologic effect of large lipid emboli in the venous circulation in conjunction with orthopedic surgery, and found adverse hemodynamic and respiratory effects [ 15 - 17 ]. However, little is known about the effect that numerous lipid micro-emboli, as found in shed blood collected from the pericardium during cardiac surgery, may have on the pulmonary circulation.…”