Pr. Wolinsky et al., EFFECTS ON PULMONARY PHYSIOLOGY OF REAMED FEMORAL INTRAMEDULLARY NAILING IN AN OPEN-CHEST SHEEP MODEL, Journal of orthopaedic trauma, 10(2), 1996, pp. 75-80
We have recently developed an open-chest sheep model to monitor and st
udy the effects of major orthopedic procedures on pulmonary physiology
. In this pilot study, we focused on reamed intramedullary femoral nai
ling in animals without pulmonary injury. Details of the model are des
cribed herein. The control group consisted of sheep that underwent tho
racotomy and invasive monitoring only, while the study group also unde
rwent femoral osteotomy, reaming, and intramedullary nailing. Baseline
, postthoracotomy, and postreaming/nailing values were recorded for me
an pulmonary arterial pressure, central venous pressure, left arterial
pressure, dynamic compliance, arterial blood gas, mixed venous O-2, c
ardiac index, and mean arterial pressure so that hemodynamic and oxyge
n transport data could be calculated, Postprocedure values were record
ed at hourly intervals for 4 h. A physiologically stable, reproducible
model was created. No statistically significant differences were foun
d between the control and experimental groups, indicating no adverse e
ffect of femoral reaming/nailing. In one animal, using echocardiograph
y, pulmonary embolization was documented while reaming and inserting t
he intramedullary nail. Reamed femoral intramedullary nailing is not d
etrimental to sheep with otherwise normal lungs. This finding suggests
that femoral reaming and nailing in trauma patients without associate
d pulmonary injuries and otherwise normal lungs may be carried out wit
hout risk of inducing significant respiratory complications.