In this study, we analyzed two cases of pure cerebral fat embolism and reviewed related literatures to explore the pathogenesis, clinical manifestations, diagnosis and treatment of cerebral fat embolism, improve the treatment efficiency and reduce the misdiagnosis rate. In our cases, patients fully returned to consciousness at the different times with good prognosis, normal vital signs and without obvious sequelae. For patients with the limb fractures, who developed coma without chest distress, dyspnea or other pulmonary symptoms 12 or 24 h post injury, cerebral fat embolism should be highly suspected, except for those with intracranial lesions, such as delayed traumatic intracerebral hemorrhage, etc. The early diagnosis and comprehensive treatment can improve prognosis.
Adult ; Embolism, Fat ; diagnosis ; etiology ; therapy ; Humans ; Intracranial Embolism ; diagnosis ; etiology ; therapy ; Male

OBJECTIVE: To observe the intervention effect of damage control orthopaedic(DCO) strategy on fat embolism syndrome(FES) associated with long shaft fracture of lower limbs. METHODS: Retrospective analysis was made on the clinical data of 163 patients with FES associated with lower limb long shaft fractures admitted from January 2015 to May 2021. They were divided into two groups based on the time point of implementing DCO strategy in January 2018. Total of 92 patients were admitted from January 2015 to December 2017 as the control group, and other 71 patients were admitted from January 2018 to May 2021 as the intervention group. The hospital mortality, arterial oxygen saturation (SaO₂), arterial partial pressure of oxygen (PaO₂) and oxygenation index (OI), hemoglobin (Hb), platelet count(PLT), Harris score of hip joint, HSS score of knee joint, AOFAS score of ankle joint, clinical efficacy and complications were observed and compared between two groups. RESULTS: Total of 163 patients were followed up for 12 to 18 months with an average of (16.91±1.22) months. The in-hospital mortality rate in the intervention group was 2.82% (2/71), and that in the control group was 16.30% (15/92), the difference between two groups was statistically significant(χ²=6.455, P<0.05). After the intervention, SaO₂, PaO₂ and OI in two groups were higher than those before the intervention(P<0.05), and after the intervention, SaO₂, PaO₂ and OI in two groups were statistically significant(P<0.05). Hb and PLT in two groups after intervention were higher than those before intervention (P<0.001), and there was statistically significant difference in Hb and PLT between two groups after intervention (P<0.05). The Harris score of hip joint, HSS score of knee joint and AOFAS score of ankle joint in both groups after 3 months of treatment were better than those before treatment (P<0.05). The total clinical effective rate of the intervention group was higher than that of the control group(χ²=4.194, P<0.05). The total incidence of complications in the intervention group was lower than that in the control group(χ²=4.747, P<0.05). CONCLUSION DCO strategy is helpful to reduce the in-hospital mortality of patients with FES associated with long shaft fracture of lower extremities, eliminate FES symptoms and stabilize vital signs, gain time advantage for phase Ⅱ definitive surgery, and has significant clinical intervention effect, which is worth popularizing.
Humans ; Orthopedics ; Retrospective Studies ; Fractures, Bone ; Treatment Outcome ; Lower Extremity ; Embolism, Fat/therapy*

Brain Damage, Chronic ; drug therapy ; Dexamethasone ; therapeutic use ; Embolism, Fat ; diagnosis ; drug therapy ; Female ; Humans ; Intracranial Embolism ; diagnosis ; drug therapy ; Magnetic Resonance Imaging ; Middle Aged

BACKGROUNDPulmonary lipiodol embolism after transarterial chemoembolization (TACE) was rare and life-threatening, occasionally reported in previous literatures. We aimed to review the records of 11 patients with pulmonary oily embolism and analyze their characteristics of radiographic findings and risk factors.

METHODSRecords of 478 consecutive patients who underwent 1 026 percutaneous TACE procedures were retrospectively analyzed. Eleven cases with respiratory symptoms were identified as having symptomatic pulmonary lipiodol embolism after TACE. Data of these patients, including clinical presentation, techniques of TACE, imaging features of tumor and chest imaging findings, were assessed.

RESULTSEleven (2.3%) of 478 consecutive patients who underwent percutaneous TACE procedures had a pulmonary oily embolism after procedures. The mean size of target tumors embolized was (13.6 ± 2.0) cm. All were hyper-vascular. The mean volume of lipiodol was (21.8 ± 8.2) ml. Pulmonary oily embolisms were revealed within 12-48 hours after TACE. The most severe respiratory symptoms and imaging abnormalities of the eight patients who survived presented between 2 and 5 days after TACE, becoming normal between 12 and 35 days after TACE. Three patients died. Chest CT revealed retention of radiopaque lipiodol in lungs.

CONCLUSIONSPulmonary lipiodol embolism occurs easily in patients who have large hyper-vascular hepatic malignant tumor. The high-density lipiodol deposition in the lung field can be used as diagnostic feature.

Antineoplastic Agents ; adverse effects ; Chemoembolization, Therapeutic ; adverse effects ; Embolism, Fat ; etiology ; Ethiodized Oil ; adverse effects ; Humans ; Liver Neoplasms ; therapy ; Pulmonary Embolism ; diagnostic imaging ; etiology ; Radiography, Thoracic ; Retrospective Studies

Adult ; Aged ; Aged, 80 and over ; Embolism, Fat ; diagnosis ; drug therapy ; pathology ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo analysis and discuss the early diagnosis and treatment of fat embolism syndrome caused by the injuries in Wenchuan earthquake happened in May 12th, 2008.

METHODSTo carry out dynamic blood and oxygen analysis and blood routine examination for the 13 fat embolism syndrome patients wounded in the earthquake, and combine with clinical features and early diagnosis, inject hydrocortisone injection, dextran 40 glucose injection and Dan Shen Root injection. Meanwhile, pay attention to supporting the respiratory function and correcting hypoxemia.

RESULTSOf 13 patients, 12 cases were rescued successfully, and the successful rate was 92.3%, while one cases died from respirometric failure with fat embolism syndrome and secondary hemorrhagic pneumonia.

CONCLUSIONSThe key to treating fat embolism syndrome is the early diagnosis and timely and accurate treatment. Supporting the respiratory function, correcting hypoxemia and early high-dose combination of hormone treatment are the effective treatment methods.

Adult ; Early Diagnosis ; Earthquakes ; Embolism, Fat ; diagnosis ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Wounds and Injuries ; complications

OBJECTIVETo improve the diagnosis and treatment of severe cerebral fat embolism (SCFE).

METHODSThe data of nine patients with SCFE were retrospectively analyzed. The manifestations of the central nerve system, respiratory system and hemorrhage were recorded, at the same time, accessory examination including arterial oxygen, fat macroglobules in venous blood and image examination was adapted. The patients were treated with exopexy, pharmocotherapy and oxygentherapy.

RESULTSTwo of the nine patients died of severe complications, the other seven recovered without severe sequela.

CONCLUSIONSGurd standard should be improved for early diagnosis of SCFE. If svere complications can be prevented, patients who receive early treatment will have favourable prognosis.

Accidental Falls ; Accidents, Traffic ; Adolescent ; Adult ; Cause of Death ; China ; Combined Modality Therapy ; Embolism, Fat ; diagnosis ; mortality ; therapy ; Female ; Humans ; Intracranial Embolism ; diagnosis ; mortality ; therapy ; Male ; Middle Aged ; Multiple Trauma ; Retrospective Studies ; Risk Assessment ; Sampling Studies ; Severity of Illness Index ; Survival Analysis

Adrenal Cortex Hormones ; therapeutic use ; Adult ; Embolism, Fat ; drug therapy ; etiology ; Evidence-Based Medicine ; Fractures, Bone ; complications ; Humans ; Male ; Treatment Outcome