[Dyspnea or confusion after trauma? Consider fat embolism syndrome].
Three patients, 2 women aged 26 and 19 years and a 65-year-old man, underwent surgical fracture treatment after a motor vehicle accident with fractures of the lower extremity. They developed respiratory distress from fat embolism syndrome. After maximal support in the ICU 2 of them died and 1 recovered. Fat embolism syndrome is a clinical condition mostly seen after long bone fractures. The main features are respiratory distress, cerebral confusion and a petechial rash. Usually the presentation is quite benign, but severe morbidity and even mortality can occur in some cases. It is caused by a combination of a mechanical and a biochemical pathway. Therapeutic options consist of respiratory and haemodynamic support. Preventive measures are rapid fracture fixating, good analgesia, adequate fluid infusion and tissue oxygenation.
van den Brand
J G
JG
Afd. Chirurgie, Bosch Medicentrum, 's-Hertogenbosch.
van der Hoeven
J H
JH
Olsman
J G
JG
D000063:Accidents, Traffic; D000328:Adult; D000368:Aged; D003221:Confusion / Q000209:etiology; D003422:Critical Care / Q000379:methods*; D003937:Diagnosis, Differential; D004620:Embolism, Fat / Q000150:complications* / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D017809:Fatal Outcome; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects*; D006801:Humans; D007869:Leg Injuries / Q000150:complications / Q000601:surgery; D008297:Male; D011693:Purpura / Q000209:etiology; D012128:Respiratory Distress Syndrome / Q000209:etiology