Analyzing fat embolism syndrome in trauma patients at AIIMS Apex Trauma Center, New Delhi, India

Fat embolism syndrome (FES) is a life-threatening condition in which multiorgan dysfunction manifests 48–72 hours after long bone or pelvis fractures. Right ventricular (RV) failure, especially in the setting of pulmonary hypertension, is a frequent feature of FES. We report our experience treating 2 young, previously healthy trauma patients who developed severe hypoxemia in the setting of FES. Neither patient had evidence of RV dysfunction on echocardiogram. The patients were treated with inhaled nitric oxide (NO), and their oxygenation significantly improved over the subsequent few days. Neither patient developed any cardiovascular compromise. Patients with FES that have severe hypoxemia and evidence of adult respiratory distress syndrome (ARDS) are likely at risk for developing RV failure. We recommend that these patients with FES and severe refractory hypoxemia should be treated with inhaled NO therapy prior to the onset of RV dysfunction.

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Risk Stratification Algorithm for Orthopedic Trauma Patients at Risk for Fat Embolism Syndrome

Indian Journal of Orthopaedics ◽

10.1007/s43465-021-00365-x ◽

2021 ◽

Author(s):

Andrew Lowery ◽

Vineet Naran ◽

Robert Ames ◽

Akul Patel ◽

Frederick Ramsey ◽

...

Keyword(s):

At Risk ◽

Risk Stratification ◽

Fat Embolism ◽

Trauma Patients ◽

Orthopedic Trauma ◽

Fat Embolism Syndrome ◽

Embolism Syndrome ◽

Patients At Risk

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Bronchoalveolar Lavage for Rapid Diagnosis of the Fat Embolism Syndrome in Trauma Patients

Annals of Internal Medicine ◽

10.7326/0003-4819-113-8-583 ◽

1990 ◽

Vol 113 (8) ◽

pp. 583 ◽

Cited By ~ 83

Author(s):

Jean Chastre

Keyword(s):

Bronchoalveolar Lavage ◽

Fat Embolism ◽

Rapid Diagnosis ◽

Trauma Patients ◽

Fat Embolism Syndrome ◽

Embolism Syndrome

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The fat embolism syndrome as a cause of paraplegia

SAGE Open Medical Case Reports ◽

10.1177/2050313x18789318 ◽

2018 ◽

Vol 6 ◽

pp. 2050313X1878931 ◽

Cited By ~ 1

Author(s):

Siert TA Peters ◽

Marieke J Witvliet ◽

Anke Vennegoor ◽

Birkitt ten Tusscher ◽

Bauke Boden ◽

...

Keyword(s):

Damage Control ◽

Vena Cava ◽

Damage Control Surgery ◽

Fat Embolism ◽

Trauma Patients ◽

Optimal Care ◽

Fat Embolism Syndrome ◽

Femur Fractures ◽

Embolism Syndrome ◽

Accident Victim

The fat embolism syndrome is a well-known complication in trauma patients. We describe a rare case of traumatic fat embolism that leads to paraplegia. A 19-year-old male motorcycle accident victim was presented to our hospital. After stabilization and trauma survey, he was diagnosed with bilateral femur fractures, a spleen laceration and a tear in the inferior vena cava, for which damage control surgery was performed. Post-operatively, the patient became paraplegic and developed a fluctuating consciousness, respiratory distress and petechiae. Fat embolism syndrome was considered as the most plausible cause of the paraplegia. The fat embolism syndrome is seen in approximately 1% of trauma patients, mostly those with bilateral fractures of the femur. Prevention of the syndrome depends on early stabilization of fractures. However, even with optimal care, this syndrome can still occur and may have dramatic consequences, as we demonstrate in this case.

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