Use of Pulmonary Diffusing Capacity Measurements to Detect Unsuspected Fat Embolism 1,2

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Abstract
Attempts were made to detect clinically unsuspected pulmonary fat embolism by serial measurements of the diffusing capacity of the lung for carbon monoxide (Dlco). The results from 17 patients with fractures of one or more long bones were compared with those from a control group of 19 patients hospitalized for minor orthopedic conditions. The most striking finding was an initial elevation in Dlco, compared to subsequent values, in both groups of patients; this was probably caused by an increase in pulmonary capillary blood volume from a redistribution of total circulating blood volume into the lungs. The patients with fractures had lower values for Dlco than the control patients during days 3 to 8; although this difference was not significant, it might have been caused by fat emboli.

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