Bronchoalveolar lavage in trauma patients for diagnosis of fat embolism syndrome.
Fat embolism syndrome (FES) is a rare but serious complication occurring after long bone fractures. Presence of fat droplets in cells obtained by bronchoalveolar lavage has been proposed as a specific tool for FES diagnosis in trauma patients. We evaluated this technique over a 15-month period in 85 patients. Twenty-eight patients were excluded. The remaining 57 patients were divided into three groups: group 1, 26 patients without trauma as control; group 2, 22 patients with trauma but without evidence of FES; and group 3, nine patients with trauma and evidence of FES. Six of 26 patients in group 1 and nine of 22 patients in group 2 exhibited fat droplets in alveolar macrophages, whereas three of nine patients of group 3 had not. This study suggests that (1) presence of fat droplets in alveolar macrophages is not a reliable method for diagnosis of FES after long bone trauma, and (2) many conditions are associated with fat droplets in alveolar macrophages.
Vedrinne
J M
JM
Service d'Anesthesie-Reanimation, Hopital Edouard Herriot, Lyon, France.
Guillaume
C
C
Gagnieu
M C
MC
Gratadour
P
P
Fleuret
C
C
Motin
J
J
D000328:Adult; D001992:Bronchoalveolar Lavage Fluid / Q000473:pathology*; D002452:Cell Count; D004620:Embolism, Fat / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D008055:Lipids / Q000032:analysis; D008264:Macrophages / Q000648:ultrastructure; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D014617:Vacuoles / Q000648:ultrastructure; D014947:Wounds and Injuries / Q000150:complications*
D008055:Lipids