• Zhongguo Wei Zhong Bing Ji Jiu Yi Xue · Nov 2009

    [Experimental study of early blood purification in the treatment of post traumatic pulmonary fat embolism].

    • Fei-hu Zhou, Hui Yue, Jun Ji, and Qing Song.
    • Department of Surgical Intensive Care Unit, PLA General Hospital, Beijing 100853, China.
    • Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2009 Nov 1; 21 (11): 672-5.

    ObjectiveTo study the effect of early continuous blood purification (CBP) in the treatment of post-traumatic pulmonary fat embolism in dog.MethodsTwelve healthy male mongrel dogs were randomly divided into two groups: group A received intramedullary reaming and bone cement injection of bilateral femurs (n=6), and group B received CBP simultaneously at the beginning of the same operation and continued until 120 minutes after the end of the operation (n=6). The changes in arterial blood gas and related cytokines were monitored at various time points. The animals were sacrificed 120 minutes after the operation, and the lungs were obtained for examination, and the amount of oil red O stained fat emboli was recorded.ResultsIn group A, the mean pulmonary arterial pressure (MPAP), pulmonary capillary wedge pressure (PCWP) and extravascular lung water (EVLW) increased after the manipulation in single femur, and these changes persisted after the manipulation on both femurs (all P<0.05). There was a decrease in pH and arterial partial pressure of oxygen (PaO2) and an increase in arterial partial pressure of carbon dioxide (PaCO2), tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta) and IL-6 after the operation on both femurs, showing significant differences compared with those of pre-operation period (all P<0.05). In group B, the hemodynamics, contents of cytokines and arterial blood gases were stable. Compared with those of group A, there was a significant decrease in the number of pulmonary fat emboli in group B (4.17+/-1.99 vs. 18.13+/-6.25, P<0.05).ConclusionThe therapy of CBP could decrease the level of the serum TNF-alpha, IL-1 beta , IL-6 and EVLW, MPAP, PCWP, which could ameliorate gas exchange and oxygenation of the lung. And it also could reduce the number of pulmonary fat emboli and decrease the incidence of pulmonary fat embolism caused by femoral intramedullary operation.

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