fat embolism syndrome


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fat embolism syndrome

Emboli composed of fat are common, relatively innocuous and may occur in alcoholism, BM biopsy, cardiopulmonary bypass, compression injury, DM, lymphangiography, pancreatitis, sickle cell anemia, corticosteroid therapy; contrarily, the FES is neither common nor trivial; clinically significant FE may be endogenous or exogenous in origin; most are due to major fractures, especially of long bones, and trauma to parenchymal organs–eg, the liver–most deaths in the immediate post-trauma period have significant fat embolism, burns, blast injury, severe infections, especially α-toxin-producing Clostridium spp Clinical Hypoxia–50% of femoral shaft fractures have ↓ arterial PO2 within the first few days, acute onset of dyspnea, tachypnea, cyanosis, tachycardia with sudden onset of right-sided cardiac failure, showers of petechiae, thrombocytopenia, cerebral embolism–with changes in personality, confusion, drowsiness, weakness, agitation, spasticity, defects of the visual field, and rarely, extreme pyrexia Diagnosis It had been reported that fat droplets in a BAL was indicative of fat embolism, a finding which in one small–34 group of Pts proved to have a low specificity of 26.5%; > 3% oil red O positive macrophages in the BAL are often found in trauma Pts, and may indicate FES or silent FE Treatment No therapy is effective. See Embolism.
References in periodicals archive ?
Occasionally, non-traumatic pathologies can be responsible for the fat embolism syndrome (2).
Diagnosis of fat embolism syndrome maybe difficult and is based on clinical findings and radiological images.
Early surgical fixation of long bone fractures prevents motion at the fracture site and decreases the incidence of the fat embolism syndrome (6).
Specificity of broncho-alveolar lavage for the diagnosis of fat embolism syndrome.
Although the diagnosis of fat embolism syndrome is usually based on clinical findings, we describe ill-defined centrilobular and subpleural nodules in addition to ground-glass opacities and consolidation on a computed tomography scan of the chest in a trauma patient with fat embolism syndrome.
Fat embolism syndrome is a rare, poorly understood but serious complication which occurs after the direct entry of fat globules into the systemic circulation.
As opposed to computed tomography (CT) findings in other forms of ARDS, radiological features have only been described occasionally in severe fat embolism syndrome.