The role of embolic fat in post-traumatic pulmonary insufficiency. An evaluation of the pulmonary haemodynamics and blood gas levels.

Pulmonary haemodynamic and arterial blood gas changes were measured in dogs subjected to either an intravenous injection of triolein or external trauma, which produced fractures of the ipsilateral femur, tibia and fibula. Musculoskeletal trauma resulted in pulmonary vasoconstriction followed by vasodilatation, arterial hypoxia with a pulmonary shunt of 30% and a 20% decrease in systemic oxygen delivery. Lipid injection produced an increased pulmonary vascular resistance, but no significant hypoxia, pulmonary shunting or inadequate tissue oxygenation. We therefore suggest that pulmonary fat embolism does not account for the pulmonary insufficiency following musculoskeletal trauma.