34 



Scientific Proceedings (87). 



128 (1306) 



Fat emboli and shock. 



By C. J. WlGGERS. 1 



[From the Physiological Laboratory, Cornell University Medical Col' 



lege, New York.) 



Among the many explanations as to the cause of the circulatory 

 failure in clinical as well as experimental shock, the theory that 

 it is caused by fat embolism has been recently suggested. At 

 least two distinct views as to the manner in which fat emboli may 

 produce the circulatory failure are held: According to Porter (1), 

 as we understand his view, fat, injected intravenously or gaining 

 access to the venous circulation after fractures or laceration of 

 the subcutaneous tissues, passes through the pulmonary vessels 

 but lodges in the peripheral systemic vessels and thereby produces 

 circulatory failure by some mechanism as yet not clearly explained. 

 According to Bissell (2) the circulatory failure of postoperative 

 or traumatic shock is caused by the lodgement of fat emboli in 

 the pulmonary vessels, making it synonymous with pulmonary 

 embolism. 



During the past ten weeks we have re-investigated the follow- 

 ing questions: (1) Is the mechanism by which the circulation 

 fails after intravenous injection of oil the same as that following 

 operation? (2) Is circulatory failure following fat injection pri- 

 marily due to emboli of the pulmonary or systemic vessels? 

 (3) Do fatcy emboli of the systemic vessels produce circulatory 

 failure similar to that following operation and trauma? To do 

 this the mean pressure in the carotid artery, pulmonary artery 

 and the effective pressures in the left and right auricles were 

 studied in naturally breathing animals. 



Experiments showed that when the circulation fails during 

 shock produced by exposing the intestines, the pressures in the 

 systemic and pulmonary arteries fall and a marked reduction of 

 the actual, as well as the effective venous pressures in the right 

 auricle takes place. These dynamic changes, which we regard 



1 This research was carried out in collaboration with Miss A. Kuehner, Messrs. 

 H. Belcher, H. Cooper, W. Dodd, R. Douglass, M. Hoisted and J. Sutton, Jr. 



