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Clinical Notes
January 4, 1964

Pulmonary Bone Marrow Emboli in Patients Receiving External Cardiac Massage

JAMA. 1964;187(1):59-60. doi:10.1001/jama.1964.03060140065023

FAT EMBOLISM involves either the pulmonary or the systemic circulation. The most frequent cause is skeletal fractures.1-3 Other causes of fat emboli include jarring of the skeleton,4 soft tissue injury,5 liver rupture," burns,7 poisons,8 clostridial infection,9 and diabetes.10

In 1960, Kouwenhoven and colleagues11 described a method of external cardiac massage and established it as a therapeutic measure for cardiac arrest. Since that time it has achieved widespread usage but the following complications have been noted: fractured ribs and sternum, subcapsular hematoma and rupture of the liver, pulmonary lacerations with hemothorax and pneumothorax, and pulmonary marrow emboli.12,13

The present study deals with bone marrow emboli subsequent to external cardiac massage.

Methods and Materials  During the past year, pulmonary marrow emboli in the absence of previous trauma was observed in increased incidence in routine autopsy material. External cardiac massage was thought to be

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