Continuous Pulse Oximeter Monitoring for Inapparent Hypoxemia after Long Bone Fractures

Wong, Margaret Wan Nar; Tsui, Hon For; Yung, Patrick Shu‐Hang; Chan, Kai Ming; Cheng, Jack C. Y.

doi:10.1097/01.ta.0000064450.02273.9b

Cited by 27 publications

(18 citation statements)

References 28 publications

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“…It is also recognised that many patients with long bone fractures may develop hypoxaemia even in the absence of injury to the airway or chest (possibly due to opiate treatment and fat embolism) and they should be monitored with oximetry and given oxygen if necessary 30 197 – 199. These patients, if not critically ill, should have a target oxygen saturation of 94–98% or 88–92% if they have co-existing COPD or other risk factors for hypercapnic respiratory failure.…”

Section: Section 8: Emergency Oxygen Use In Hospital Settingsmentioning

confidence: 99%

BTS guideline for emergency oxygen use in adult patients

O’Driscoll

Howard

Davison³

2008

Thorax

534

535

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Section: Section 8: Emergency Oxygen Use In Hospital Settingsmentioning

confidence: 99%

BTS guideline for emergency oxygen use in adult patients

O’Driscoll

Howard

Davison³

2008

Thorax

534

535

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“…Another useful tool[34] in such situations may be the non-invasive assessment of hypoxia using the continuous pulsoximeter. It is considered to be a superior indicator of hypoxia than arterial blood gas analysis, since that an uninterrupted, non-invasive monitoring enables the detection of even transient episodes of hypoxia.…”

Section: Discussionmentioning

confidence: 99%

Early, reliable, utilitarian predictive factors for fat embolism syndrome in polytrauma patients

Gopinathan¹,

Sen²,

Viswanathan³

et al. 2013

Indian Journal of Critical Care Medicine

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Background:Fat embolism is one of the apocalyptic pulmonary complications following high energy trauma situations. Since delay in diagnosis may have devastating consequences, early, easily accessible and relatively inexpensive investigations for risk stratification may prove useful, especially in developing nations.Materials and Methods:This prospective trial included a total of 67 young polytrauma patients, in whom the role of nine easily available, rapidly performable clinical or laboratory investigations (or observations noted at admission) in predicting the later occurrence of fat embolism syndrome were assessed. All the patients also underwent continuous monitoring of oxygen saturation with pulsoximetry.Results:The correlation between initial serum lactate (within 12 hours of injury) and hypoxia was statistically significant. There was a trend towards correlation with FES(by Gurd's criteria) (P=0.07), Sensitivity of 24-hour monitoring of oxygen saturation in predicting later pulmonary deterioration approached 100%.Conclusions:The combination of three factors including polytrauma (with NISS >17), serum lactate >22 mmol/l at admission (within 12 hours of injury) fall in oxygen saturation (SaO2 below 90% in the initial 24 hours) predict the development of post-traumatic pulmonary complications, especially the fat embolism syndrome.

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“…[13] Medications including steroids, heparin, alcohol, and dextran have been tried but with uncertain benefit. [7]…”

Section: Discussionmentioning

confidence: 99%

Multimodal imaging tools for diagnosis of fat embolism

Shobha

Bermejo²,

Bhatia³

et al. 2011

J Emerg Trauma Shock

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It is important to consider several differential diagnoses in a patient presenting with altered sensorium following surgery. Fat embolism syndrome (FES) is a serious condition that needs to be excluded. Although criteria for diagnosis of FES are available, all patients may not satisfy them. We discuss a patient who presented with an incomplete triad of the FES, where the diagnosis was supported by transcranial doppler monitoring of microembolic signals and magnetic resonance imaging.

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Continuous Pulse Oximeter Monitoring for Inapparent Hypoxemia after Long Bone Fractures

Cited by 27 publications

References 28 publications

BTS guideline for emergency oxygen use in adult patients

BTS guideline for emergency oxygen use in adult patients

Early, reliable, utilitarian predictive factors for fat embolism syndrome in polytrauma patients

Multimodal imaging tools for diagnosis of fat embolism

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