Incidence of Pulmonary Fat Embolism at Autopsy: An Undiagnosed Epidemic

Eriksson, Evert A.; Pellegrini, Daniela; VanderKolk, Wayne E.; Minshall, Christian T.; Fakhry, Samir M.; Cohle, Stephen D.

doi:10.1097/ta.0b013e3182208280

Cited by 69 publications

(53 citation statements)

References 21 publications

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“…Interestingly, it is seen more frequently in closed fractures than open fractures and risk increases in proportion with the number of bone structures involved. Inone series, over 85 percent of all patients who received cardiopulmonary resuscitation had evidence of fat embolism [5].…”

Section: Discussionmentioning

confidence: 96%

Fat Embolism Syndrome – A Case Report with Literature Review

Gomez¹,

IshaVerma²,

L³

et al. 2015

MOJCR

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Background: The fat embolism syndrome (FES) has been considered a diagnostic enigma since its first description over a century ago. Varying degree of presentation along with absence of specific diagnostic criteria or a scoring system makes it difficult to be diagnosed. Simple fat embolism may be a pathologic finding with variable clinical significance; patients with the FES have fat emboli in multiple organs, causing extensive organ dysfunction. While most patients with FES fully recover, there is an estimated 5to15percent mortality rate. There is no wide accepted specific treatment beyond aggressive supportive care.Case Report: A 72 year old Caucasian female presented with dyspnea, hypoxia and altered mental status within 24 hours of admission for an inferior pubic rami fracture secondary to fall. Patient required intubation and mechanical ventilation for respiratory failure. An Echocardiogram revealed Right Ventricular strain and MRI of the brain showed multiple acute/subacute infarcts, which supported a diagnosis of FES, especially as pulmonary embolism was deemed less likely with a negative CT Chest Angiogram and US Doppler of Legs. The patient gradually recovered with supportive care, successfully extubated with eventually discharged after thirty days of hospitalization. Conclusion:Fat emboli syndrome has a variable degree of presentation, ranging from mild symptoms to severe multi organ involvement that can ultimately be fatal. It can also be associated with long term morbidity which emphasizes the need for rapid precise diagnosis and management.

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Section: Discussionmentioning

confidence: 96%

Fat Embolism Syndrome – A Case Report with Literature Review

Gomez¹,

IshaVerma²,

L³

et al. 2015

MOJCR

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show abstract

“…In clinical practice, corticosteroids are routinely administered; however, there are no sufficient evidences for its effectiveness (True) (9). Using heparin for systemic anticoagulation may accelerate the clearance of lipid drops from the circulation, but it may exacerbate the underlying proinflammatory physiology (10). In this way, the best treatment modality of FES is supportive intensive care unit-level treatment.…”

Section: Discussionmentioning

confidence: 99%

Fat Embolism Syndrome after Lower Extremity Fracture

Sayhan¹,

Salt²,

Özcan³

et al. 2016

J Emerg Med Case Rep

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There also exists a diagnostic tool to help the diagnosis of FES called the "fat embolism index (FEI)". This index was prepared by Schonfeld, and a total score of five or more in the first three days of hospitalization supports the diagnosis of FES (6) (Table 2).Fat embolism syndrome can also be seen in the situation of pancreatitis. In this case report, we present a rare case of FES after a traumatic fracture of the tibia and fibula.

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“…Lethal outcomes are usually due to massive pulmonary fat embolism, but BME may be lethal on its own, mostly in patients suffering from underlying sickle cell disease or thalassaemia 11 23 24…”

Section: Discussionmentioning

confidence: 99%