Latent Severe Anoxia Associated With the Fat Embolism Syndrome

Abstract

Fat embolism syndrome was diagnosed in a 41-year-old man 42 hours after a road traffic accident. Latent severe anoxia was present and persisted despite endotracheal intubation and administration of oxygen when breathing was spontaneous. Oxygenation was restored almost immediately after instituting intermittent positive pressure ventilation. The need for frequent estimations of blood-gas tensions or oxygen saturation is emphasized. Pulmonary fat embolism is found at necropsy in 90-100 per cent of patients who have died shortly after receiving fractures (Sevitt, 1966) but clinical manifestations of this embolism develop in less than 2 per cent (Wilson and Salisbury, 1944; Saikku, 1954). The features most commonly associated with the fat embolism syndrome are: pyrexia, tachycardia, tachypnoea, haemoptysis, variable neurological signs, coma and a petechial rash. The following case is reported because it confirms recent evidence of latent severe anoxia associated with the fat embolism syndrome.