title: The effect of patient position during trauma surgery on fat embolism syndrome: An experimental study.
abstract: BACKGROUND
  The aim of this study was to compare the effect of supine versus lateral position on clinical signs of fat embolism during orthopedic trauma surgery. Dogs served as the current study model, which could be extended and/or serve as a basis for future in vivo studies on humans. It was hypothesized that there would be an effect of position on clinical signs of fat embolism syndrome in a dog model.
  
  
  METHODS
  12 dogs were assigned to supine (n = 6) and lateral (n = 6) position groups. Airway pressures, heart rate, blood pressure, cardiac output, pulmonary artery pressure, pulmonary artery wedge pressure, right atrial pressure, arterial and venous blood gases, white blood count, platelet count and neutrophil count were obtained. Dogs were then subjected to pulmonary contusion in three areas of one lung. Fat embolism was generated by reaming one femur and tibia, followed by pressurization of the canal.
  
  
  RESULTS
  No difference was found in any parameters measured between supine and lateral positions at any time (0.126 < P < 0.856).
  
  
  CONCLUSIONS
  The position of trauma patients undergoing reamed intramedullary nailing did not alter the presentation of the features of the lung secondary to fat embolism.
authors.affiliation: Division of Orthopaedic Surgery, Musculoskeletal Health and Arthritis Program, Toronto Western Hospital, Toronto, Canada.
authors.forename: Khalid A
authors.initials: KA
authors.lastname: Syed
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Blankstein
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster Health Sciences Centre, Hamilton, Canada.
authors.forename: Mohit
authors.initials: M
authors.lastname: Bhandari
authors.affiliation: Department of Anesthesia, St. Michael's Hospital, Toronto, Canada.
authors.forename: Masaki
authors.initials: M
authors.lastname: Nakane
authors.affiliation: Martin Orthopaedic Biomechanics Laboratory, St. Michael's Hospital, Toronto, Canada ; Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, Canada.
authors.forename: Radovan
authors.initials: R
authors.lastname: Zdero
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Canada ; Martin Orthopaedic Biomechanics Laboratory, St. Michael's Hospital, Toronto, Canada.
authors.forename: Emil H
authors.initials: EH
authors.lastname: Schemitsch
keywords: Canine; fat embolism syndrome; position; trauma surgery
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