Fat embolism--a review.

Fulde, Gordian; Harrison, P.

doi:10.1136/emj.8.4.233

Cited by 79 publications

(57 citation statements)

References 17 publications

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“…3,6,7 Pulmonary manifestations, including dyspnea, tachypnea, and hypoxemia, are generally the first to appear and occur in approximately 75% of FES patients. 7,9 A total of 10% to 50% of patients progress to respiratory failure and acute respiratory distress syndrome, often requiring mechanical ventilation 2,3,7 because of an inflammatory process triggered by fat emboli that leads to hemorrhage and the leaking of proteins into the alveoli. 10 The neurological manifestations occur in more than 80% of patients and may include restlessness, acute confusion, altered level of consciousness, focal deficits, and seizures.…”

Section: Discussionmentioning

confidence: 99%

“…2 Cutaneous signs and symptoms occur in up to 60% of FES patients and include petechiae of the skin and mucous membranes. 6,9 The petechiae are nonpalpable, generally located on the thorax, axilla, and neck, and usually disappear within 1 week. 7,9 FES is often diagnosed on the basis of clinical features and the exclusion of other disease processes.…”

Section: Discussionmentioning

confidence: 99%

“…6,9 The petechiae are nonpalpable, generally located on the thorax, axilla, and neck, and usually disappear within 1 week. 7,9 FES is often diagnosed on the basis of clinical features and the exclusion of other disease processes. The current diagnostic criteria for FES do not require the presence of all 3 aspects of the FES triad for a diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…7,14 Albumin may be useful in restoring blood volume because it binds with fatty acids and may decrease the extent of injury caused by the fat emboli. 5,7,9 In addition, corticosteroids may help prevent FES and result in some improvement in patients' outcomes because the drugs are associated with better oxygenation and a reduction in circulating fatty acids. 6,7,14,15 Treatment must also focus on managing the injuries with early fracture fixation to ensure that no additional fat emboli enter the circulation.…”

Section: Continued From Page 267mentioning

confidence: 99%

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Fat Embolism Syndrome After Femur Fracture With Intramedullary Nailing: Case Report

Powers

Talbot

2011

American Journal of Critical Care

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Fat embolism syndrome is a life-threatening condition that can develop after orthopedic injury and surgery. This syndrome developed in a 19-year-old man after a traumatic femoral fracture that was surgically repaired with intramedullary nailing. The complications experienced by the patient highlight the importance of prevention and early detection of fat embolism syndrome. Although minimization of the syndrome focuses primarily on prehospital care and early stabilization of a patient's condition, prevention of the potential consequences requires early detection by bedside nurses who care for trauma and orthopedic patients. Detailed nursing assessment and rapid recognition and reporting of the signs and symptoms associated with fat embolism syndrome are key to improving the outcomes of these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Continued From Page 267mentioning

confidence: 99%

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Fat Embolism Syndrome After Femur Fracture With Intramedullary Nailing: Case Report

Powers

Talbot

2011

American Journal of Critical Care

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“…Nas décadas de 1960 e 1970 a mortalidade por SEG era de 10% a 20%; em anos mais recentes, ocorreu redução para 5% a 10% (18) .…”

Section: Tabela 1 Critérios De Gurdunclassified

Síndrome de embolia gordurosa: relato de caso associado à lipoaspiração

Folador

Bier²,

Camargo³

et al. 1999

J. Pneumologia

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Mulher, 40 anos, 72 horas após lipossucção apresentou dispnéia súbita, febre, taquipnéia e taquicardia. Radiografia torácica e eco-doppler de membros inferiores eram normais, mas hipoperfusão pulmonar à cintilografia sugeriu tromboembolismo pulmonar. Após três dias de heparinização, observou-se hipóxia, anemia e confusão mental. Diagnosticou-se síndrome de embolia gordurosa, suspendeu-se heparinização e iniciou-se pulsoterapia com corticóide, seguida de melhora clínica e alta hospitalar. Pneumol 1999;25(2):114-117) SEG é caracterizada pelo aparecimento de ácidos graxos ou gordura livre na circulação sanguínea, pulmões, cérebro, rins e outros órgãos. A tríade clássica caracterizada por insuficiência respiratória aguda com infiltrado pulmonar difuso, disfunção neurológica e rash com petéquias ocorre em apenas 0,5% a 2,0% dos casos (3) .Em 90% dos casos, a SEG ocorre após trauma brusco complicado por fraturas de ossos longos, geralmente de membros inferiores. Raramente ocorre em associação com osteomielite, pancreatite aguda, diabetes melito, anemia falciforme, queimaduras, reconstruções articulares, lipoaspiração, bypass cardiopulmonar, e infusão parenteral de lipídios (4,5) .O objetivo desse relato é apresentar a associação de SEG à lipoaspiração, uma causa incomum da doença e dificuldades do seu diagnóstico. RELATO DO CASOPaciente do sexo feminino, branca, 40 anos, 72 horas após a realização de procedimento cirúrgico (histerectomia, ooforectomia e lipoaspiração) apresentou-se com dispnéia súbita e febre, evoluindo com piora progressiva em 48 horas para dispnéia aos pequenos esforços, hipertermia e mal-estar. Estava em tratamento hormonal para endometriose há INTRODUÇÃO A primeira descrição de síndrome de embolia gordurosa (SEG) foi realizada após achado em autópsia por Zenter (1) , em 1861. Após 12 anos, Von Bergman realizou seu primeiro diagnóstico clínico (2) . Embora esta síndrome seja reconhecida por mais de 100 anos, sua fisiopatologia permanece incompleta e ainda persistem discussões sobre seu diagnóstico específico e manejo clínico.

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Fat Embolism Syndrome

et al. 1997

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(1) Fat embolism syndrome remains a diagnosis of exclusion and is based on clinical criteria. (2) Clinically apparent FES is unusual but may be masked by associated injuries in more severely injured patients. (3) No association could be identified between FES and a specific fracture pattern or location. (4) Early intramedullary fixation does not increase the incidence or severity of FES. (5) While FES seems to have a direct effect on survival, the management of FES remains primarily supportive.

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Fat embolism--a review.

Cited by 79 publications

References 17 publications

Fat Embolism Syndrome After Femur Fracture With Intramedullary Nailing: Case Report

Fat Embolism Syndrome After Femur Fracture With Intramedullary Nailing: Case Report

Síndrome de embolia gordurosa: relato de caso associado à lipoaspiração

Fat Embolism Syndrome

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