Embolie graisseuse pulmonaire après liposuccion

Síndrome da angústia respiratória do adulto por embolia gordurosa no período pós-operatório de lipoaspiração e lipoenxertia

“…(4) However, reports of adverse consequences, among which are fat embolism and FES, are increasingly common. (2)(3)(4)6) Fat embolism is defined as the occurrence of mechanical blockage of the vascular lumen by circulating fat globules. Although it primarily affects the lungs, it can also affect the central nervous system, retina, and skin.…”

“…(1,7,8) The definition of FES is fat emboli-induced dysfunction of these organs, and it is a rare, albeit potentially fatal, complication of cosmetic procedures such as liposuction and fat grafting. (2)(3)(4) It typically occurs 12 to 72 h after the surgical procedure, presenting as the triad of progressive respiratory insufficiency, altered level of consciousness and petechiae. (3,4,8) Neurological alterations range from mental confusion to altered level of consciousness, and there can be generalized convulsions and focal deficits, the latter being transient and reversible in most cases.…”

“…(1)(2)(3)7,8) This hypothesis could explain the fact that the onset of symptoms occurs some time after the surgical procedure, since agglutination and degradation of the fat emboli would be necessary in order to trigger the local inflammatory process. (1)(2)(3)7,8) Clinically, post-traumatic FES is classified as "acute fulminant", "subacute", or "subclinical", and there is no standard classification for FES after cosmetic procedures. (1) The acute fulminant form occurs a few hours after the trauma, presenting as respiratory insufficiency, coma, and acute multiple organ failure.…”

“…(1) More rarely, there are reports of FES after cosmetic procedures, such as liposuction and fat grafting. (2)(3)(4) In the lungs, fulminant FES manifests as severe respiratory insufficiency and acute respiratory distress syndrome (ARDS), although the emboli can reach the arterial circulation and affect other sites, such as the central nervous system, retina, and skin. (2,3) rial oxygen tension/fraction of inspired oxygen ratio of 32 and a lung injury score of 2.6.…”

“…(2)(3)(4) In the lungs, fulminant FES manifests as severe respiratory insufficiency and acute respiratory distress syndrome (ARDS), although the emboli can reach the arterial circulation and affect other sites, such as the central nervous system, retina, and skin. (2,3) rial oxygen tension/fraction of inspired oxygen ratio of 32 and a lung injury score of 2.6. (5) Inotropic drugs were initiated due to hypotension and oliguria, and the patient developed dialytic renal insufficiency on postadmission day 3.…”