[Acute respiratory distress due to fat embolism].
BACKGROUND
Acute respiratory distress occurring in a child without any past medical history can have different origins. Pulmonary edema can be lesional or hemodynamic in origin. Bronchoalveolar lavage often allows indication of the type of lesional oedema.


METHODS
A 13-year old child was hospitalized for acute respiratory distress 24 hours after knee surgery complicated by a fracture of the tibial metaphysis. There were no clinical manifestations of airway obstruction. Chest X-ray showed pulmonary parenchymous pathology. Pulmonary edema secondary to congestive heart failure was eliminated by doppler echocardiogram. The cause of lesional pulmonary edema was found with bronchoalveolar lavage that showed fat drops in the cytoplasm of many alveolar macrophages.


CONCLUSIONS
Fat embolism syndrome may be confirmed by examination of bronchoalveolar lavage fluid.
Liet
J M
JM
Service de réanimation pédiatrique, CHRU de Nantes, France.
Moreau
A
A
Ardouin
T
T
Dahl
K
K
Roze
J C
JC
D000208:Acute Disease; D000293:Adolescent; D001992:Bronchoalveolar Lavage Fluid; D004620:Embolism, Fat / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology*
Détresse respiratoire aiguë par embolie graisseuse.