Clinical characteristics and management of patients with fat embolism syndrome in level I Apex Trauma Centre.
10.1016/j.cjtee.2019.01.007
- Author:
Richa AGGARWAL
1
;
Arnab BANERJEE
2
;
Kapil Dev SONI
3
;
Atin KUMAR
4
;
Anjan TRIKHA
5
Author Information
1. Critical and Intensive Care, JPNATC, All India Institute of Medical Sciences, New Delhi, India.
2. Department of Plastic Surgery, All India Institute of Medical Sciences, New Delhi, India.
3. Critical and Intensive Care, JPNATC, All India Institute of Medical Sciences, New Delhi, India. Electronic address: kdsoni111@gmail.com.
4. Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
5. Department of Anesthesiology, Critical Care and Pain Medicine, All India Institute of Medical Sciences, New Delhi, India.
- Publication Type:Journal Article
- Keywords:
Fat embolism;
Intensive care units;
Patient outcome assessment;
Trauma centers
- MeSH:
Adolescent;
Adult;
Central Nervous System Diseases;
etiology;
Early Diagnosis;
Embolism, Fat;
diagnosis;
etiology;
prevention & control;
Fractures, Bone;
complications;
Humans;
Hypoxia;
etiology;
Intensive Care Units;
statistics & numerical data;
Length of Stay;
statistics & numerical data;
Male;
Patient Outcome Assessment;
Time Factors;
Trauma Centers;
statistics & numerical data;
Young Adult
- From:
Chinese Journal of Traumatology
2019;22(3):172-176
- CountryChina
- Language:English
-
Abstract:
PURPOSE:Fat embolism syndrome (FES) is systemic manifestation of fat emboli in the circulation seen mostly after long bone fractures. FES is considered a lethal complication of trauma. There are various case reports and series describing FES. Here we describe the clinical characteristics, management in ICU and outcome of these patients in level I trauma center in a span of 6 months.
METHODS:In this prospective study, analysis of all the patients with FES admitted in our polytrauma intensive care unit (ICU) of level I trauma center over a period of 6 months (from August 2017 to January 2018) was done. Demographic data, clinical features, management in ICU and outcome were analyzed.
RESULTS:We admitted 10 cases of FES. The mean age of patients was 31.2 years. The mean duration from time of injury to onset of symptoms was 56 h. All patients presented with hypoxemia and petechiae but central nervous system symptoms were present in 70% of patients. The mean duration of mechanical ventilation was 11.7 days and the mean length of ICU stay was 14.7 days. There was excellent recovery among patients with no neurological deficit.
CONCLUSION:FES is considered a lethal complication of trauma but timely management can result in favorable outcome. FES can occur even after fixation of the fracture. Hypoxia is the most common and earliest feature of FES followed by CNS manifestations. Any patient presenting with such symptoms should raise the suspicion of FES and mandate early ICU referral.
