Abstract
Fat embolism, occuring as the result of trauma to fat depots, can be demonstrated clinically and experimentally. Trauma is usually considered the sole cause. However, fat embolism has been found in many non-traumatic conditions. Dogs will survive aseptic injections of cotton-seed oil in amounts per kilo body weight that are twice the amount of fat per kilo body weight in the marrow of the human femur.
It is obvious, therefore, that there must be some other etiology than trauma for some cases of fat embolism. The most logical other source for fat embolism is, of course, the normal plasma emulsion of fat.
Experiments are reported showing that certain artificial emulsions can be broken down by the addition of necrotic muscle extract, peptone and histamine, besides other substances. This breakdown varies in speed and degree inversely with the fineness of the emulsion. It has not been demonstrated in the physiological plasma emulsion of a digestive lipemia.
However, the well-known destruction of this emulsion by fat solvents was applied by the intravenous and mask administration of ether to dogs in the lipemic phase following a fat meal. Ninety-five per cent of animals so treated showed definite fat embolism in the lungs, as compared to 21 per cent of controls which were killed by many different procedures.
It is emphasized that no significance has heretofore been placed on the physical state of the normal fat in the blood-stream. This is the first experimental production of fat embolism by other than traumatic means. The possible relationship of clinical fat embolism to the presence of protein split products in the blood-stream is suggested by the breaking down of artificial emulsions by these substances.
This is a preliminary report.
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