Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-23T22:50:32.070Z Has data issue: false hasContentIssue false
  • English
  • Français

Importance of Early Fracture Stabilization in Preventing Post-Traumatic Pulmonary Changes

Published online by Cambridge University Press:  17 February 2017

I. Jansson ,
R. Eriksson ,
S.O. Liljedahl ,
L. Lovén ,
L. Rammer  and
S. Lennquist
I. Jansson
Affiliation:
Departments of Surgery, Linköping, Sweden
R. Eriksson
Affiliation:
Clinical Radiology, Linköping, Sweden
S.O. Liljedahl
Affiliation:
Departments of Surgery, Linköping, Sweden
L. Lovén
Affiliation:
Departments of Surgery, Linköping, Sweden
L. Rammer
Affiliation:
State Institute of Forensic Medicine, Linköping, Sweden
S. Lennquist
Affiliation:
Departments of Surgery, Linköping, Sweden
Get access Rights & Permissions [Opens in a new window]

Extract

Adult respiratory distress syndrome (ARDS) is the most fatal complication after severe trauma (1,3). ARDS is seen in multiple injured patients with fractures and the risk for ARDS increases with the number of fractures (9). One of the theories concerning the etiology in ARDS is, that tissue thromboplastine from the site of the fracture and surrounding soft tissue activates the coagulation system resulting in pulmonary microembolism (6). Riska (8) has noticed by clinical experience that increased frequency of early fracture stabilization by internal fixation in multiply injured patients has dramatically reduced the frequency of post-traumatic respiratory insufficiency. The aim of the present study was to investigate the effect of primary fracture immobilization on post-traumatic pulmonary changes in pigs. We used a model in which anesthetized pigs can be subjected to trauma and then observed for several days, while still under anesthesia, under careful respiratory and circulatory control, by means of repeated chest x-rays and postmortem macroscopic and microscopic examination of lung tissue.

Twenty-six pigs (Swedish Landrace), weight 17–23 kg were used. Chest x-rays were done in all animals before the experiment excluding those pigs with any pulmonary changes. The pigs were anesthetized with pentobarbital and pethidine, and tracheostomy, carotid artery cateterization and cystostomy were performed.

Type
Section Two—Clinical Topics
Information
Prehospital and Disaster Medicine , Volume 1 , Issue 3 , Fall 1985 , pp. 213 - 218
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1985

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Alm, A, Tolagen, A. Casualties with major injuries. Unfallheilkunde 1978; 81:69–76.Google ScholarPubMed
2 Blaisdell, FW. Respiratory insufficiency syndrome: Clinical and pathological definition. J Trauma 1973; 13:195–199.Google Scholar
3 Blaisdell, FW, Lewis, FR Jr., Respiratory distress syndrome of shock and trauma. Philadelphia: Saunders, 1977.Google Scholar
4 Gerdin, B, Saldeen, T. Effect of fibrin degradation products on microvascular permeability. Thromb Res 1978; 13:995.Google Scholar
5 Joachim, H, Riede, U, Mittermayer, C. The weight of human lungs as a diagnostic criterium. Path Res Pract 1978; 162:24–40.CrossRefGoogle ScholarPubMed
6 Lewis, FR, Blaisdell, FW, Schlobohm, RM. Incidence and outcome of post-traumatic respiratory failure. Arch Surg 1977; 112:436–443.Google Scholar
7 MoCostabella, P, Lindquist, O, Kapanci, , et al. Increased vascular permeability in the delayed microembolism syndrome. Experimental and human findings. Microvasc Res 1978; 15:275–286.CrossRefGoogle Scholar
8 Riska, EB, von Bonsdorf, H, Hakkinen, S, et al. Prevention of fat embolism by early internal fixation of fractures in patients with multiple injuries. Injury 1976; 8:110–116.Google Scholar
9 Rokkanen, P, Lahdensuu, J, Kataja, J, et al. The syndrome of fat embolism: Analysis of thirty consecutive cases compared to trauma patients with similar injuries. J Trauma 1970; 10:299–306.Google Scholar
10 Saldeen, T. The microembolism syndrome. Microvasc Res 1976; 11:227–259.Google Scholar