This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
This small text written by an orthopedic surgeon and a pathologist, both with extensive clinical experience, sets forth the thesis that the complex clinical situation frequently seen following severe trauma and called by the authors "The Illness of Trauma" is due primarily to fat embolism.
While they concede that pump failure and pure hypovolemic shock does exist, the authors state that "traumatic shock" is a more complex variant in which increased capillary permeability secondary to hypoxia results in fluid loss and sludging. The supposedly physiologic explanations for the changes which occur, the clinical signs and symptomatology, and therapy based on this thinking is difficult to follow in many instances. For example, the authors state that as capillary permeability increases and fluid is lost from the vascular compartment, hydrostatic pressure increases relative to osmotic pressure and blood elements and protein are forced through the capillary walls.
The authors attempt to develop
Muncrief J. The Illness of Trauma. Arch Intern Med. 1973;131(2):311. doi:10.1001/archinte.1973.00320080147037
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: