Prone positioning in a patient with fat embolism syndrome presenting as diffuse alveolar haemorrhage: new perspective

2020 ◽  
Vol 13 (3) ◽  
pp. e233452
Author(s):  
Arnab Banerjee ◽  
Richa Aggarwal ◽  
Kapil Dev Soni ◽  
Anjan Tirkha
Keyword(s):  
Prone Position ◽  
Rare Complication ◽  
Fat Embolism ◽  
Interesting Case ◽  
Alveolar Haemorrhage ◽  
Diffuse Alveolar Haemorrhage ◽  
Fat Embolism Syndrome ◽  
Embolism Syndrome ◽  
Severe Hypoxaemia ◽  
New Perspective

Diffuse alveolar haemorrhage (DAH) is a rare complication of fat embolism syndrome leading to severe hypoxaemia due to the effusion of blood into the alveoli from the damaged pulmonary microvasculature. The management is usually supportive with patients being nursed in supine position. The use of prone position ventilation in a DAH has rarely been reported before. We report an interesting case of a 26-year-old male patient diagnosed with DAH caused by fat embolism in whom prone position ventilation improved the lung dynamics and oxygenation.

scholarly journals Diffuse alveolar haemorrhage – Is it an unusual or unlooked presentation of Fat Embolism Syndrome? A Case report and review of literature

2020 ◽  
Vol 9 (1) ◽  
pp. 40-43
Author(s):  
Dipesh Maskey
Keyword(s):  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Fat Embolism ◽  
Alveolar Haemorrhage ◽  
Atypical Presentation ◽  
Review Of Literature ◽  
Fat Embolism Syndrome ◽  
Embolism Syndrome ◽  
High Index Of Suspicion ◽  
Surgical Manipulation

Fat embolism syndrome (FES) is a constellation of clinical symptoms characterized by a triad of respiratory insufficiency, altered sensorium and petechiae occurring after orthopaedic trauma or following surgical manipulation of long bones and spine. The diagnosis is based on clinical presentation and excluding other possible conditions. Beside histopathology, none of the investigations such as fat macroglobinuria in urine or lipid laden macrophages in bronchoalveolar lavage (BAL) is 100% specific. At times FES can present with atypical presentation such as intra alveolar haemorrhage and only high index of suspicion can help in making diagnosis.

Clinical case of successful treatment of compartment syndrome, complicated by fat embolism syndrome

2018 ◽  
Vol 16 (7(part 1)) ◽  
pp. 81-84
Author(s):  
I. O. Pankov ◽  
◽  
M. M. Gabdullin ◽  
S. D. Sirazitdinov ◽  
◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Successful Treatment ◽  
Clinical Case ◽  
Fat Embolism ◽  
Fat Embolism Syndrome ◽  
Embolism Syndrome

scholarly journals Late-onset isolated cerebral fat embolism syndrome after a simple tibial plateau fracture: a rare case report

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110284
Author(s):  
Ta-Li Hsu ◽  
Tien-Chi Li ◽  
Fei-Pi Lai ◽  
Ming Ouhyoung ◽  
Chih-Hung Chang ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rare Case ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Fat Embolism ◽  
Resonance Imaging ◽  
Fat Embolism Syndrome ◽  
Embolism Syndrome ◽  
Plateau Fracture

Fat embolism syndrome (FES) is a complication of long bone fractures that often occurs within 72 hours of injury. Early-onset isolated cerebral fat embolism is catastrophic and rarely reported. We herein present a rare case of delayed-onset isolated cerebral FES that developed 10 days after definite fixation of a left tibial plateau fracture. A 70-year-old woman was injured in a traffic accident and diagnosed with a left tibial plateau fracture. However, she developed sudden loss of consciousness (E4V1M1) and quadriplegia 10 days after fracture fixation. Her vital signs showed no respiratory distress. Diagnosis of isolated cerebral FES was made based on magnetic resonance imaging of the brain, the findings of which were compatible with the clinical neurological findings. After supportive care and rehabilitation, her consciousness became clear on the second day of admission, and her consciousness changed to E4V5M6. She gradually regained strength in her right limbs but had residual left limb paraplegia. Isolated cerebral FES should always be considered for patients who develop a change in consciousness, even beyond 72 hours after injury. Imaging may not initially show definitive abnormalities. Repeated magnetic resonance imaging should be considered if the initial clinical presentation does not fully meet Gurd’s criteria.

scholarly journals A rare case of fat embolism syndrome secondary to abdominal liposuction and gluteal fat infiltration

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Salvador Recinos ◽  
Sabrina Barillas ◽  
Alejandra Rodas ◽  
Javier Ardebol
Keyword(s):  
Right Ventricular Dysfunction ◽  
Signs And Symptoms ◽  
Fat Embolism ◽  
Fat Infiltration ◽  
Fat Embolism Syndrome ◽  
Embolism Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Bone Marrow Harvesting ◽  
Dermatologic Manifestations

Abstract Fat embolism syndrome (FES) is a rare, life-threatening condition habitually associated with traumatic events such as fractures and, less commonly, burns, liposuction and bone marrow harvesting and transplant [ 1]. The biochemical theory for this condition suggests that fat droplets embolize and convert into fatty acids, eventually leading to toxic injury and inflammation, which results in increased vascular permeability, edema and hemorrhage [ 2]. FES may have an asymptomatic interval lasting 12–72 hours after the insult; however, in some cases, signs have also been seen intraoperatively. Pulmonary signs and symptoms are customarily the earliest and manifest in 75% of patients. Nevertheless, neurologic and dermatologic manifestations are also characteristic, and most severe cases could perhaps present with disseminated intravascular coagulation, right ventricular dysfunction, shock or death. The following case consists of a 37-year-old patient that presented with fat embolism syndrome during liposuction and gluteal fat infiltration.

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