Cargando…
Fat embolism syndrome in long bone trauma following vehicular accidents: Experience from a tertiary care hospital in north India
BACKGROUND: Fat embolism syndrome (FES) is a clinical problem arising mainly due to fractures particularly of long bones and pelvis. Not much literature is available about FES from the Indian subcontinent. MATERIALS AND METHODS: Thirty-five patients referred/admitted prospectively over a 3-year peri...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2013
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3669567/ https://www.ncbi.nlm.nih.gov/pubmed/23741088 http://dx.doi.org/10.4103/0970-2113.110413 |
_version_ | 1782271777363197952 |
---|---|
author | Koul, Parvaiz A. Ahmad, Feroze Gurcoo, Showkat A. Khan, Umar H. Naqash, Imtiyaz A. Sidiq, Suhail Jan, Rafi Ahmad Koul, Ajaz N. Ashraf, Mohammad Bhat, Mubasher Ahmad |
author_facet | Koul, Parvaiz A. Ahmad, Feroze Gurcoo, Showkat A. Khan, Umar H. Naqash, Imtiyaz A. Sidiq, Suhail Jan, Rafi Ahmad Koul, Ajaz N. Ashraf, Mohammad Bhat, Mubasher Ahmad |
author_sort | Koul, Parvaiz A. |
collection | PubMed |
description | BACKGROUND: Fat embolism syndrome (FES) is a clinical problem arising mainly due to fractures particularly of long bones and pelvis. Not much literature is available about FES from the Indian subcontinent. MATERIALS AND METHODS: Thirty-five patients referred/admitted prospectively over a 3-year period for suspected FES to a north Indian tertiary care center and satisfying the clinical criteria proposed by Gurd and Wilson, and Schonfeld were included in the study. Clinical features, risk factors, complications, response to treatment and any sequelae were recorded. RESULTS: The patients (all male) presented with acute onset breathlessness, 36-120 hours following major bone trauma due to vehicular accidents. Associated features included features of cerebral dysfunction (n = 24, 69%), petechial rash (14%), tachycardia (94%) and fever (46%). Hypoxemia was demonstrable in 80% cases, thrombocytopenia in 91%, anemia in 94% and hypoalbuminemia in 59%. Bilateral alveolar infiltrates were seen on chest radiography in 28 patients and there was evidence of bilateral ground glass appearance in 5 patients on CT. Eleven patients required ventilatory assistance whereas others were treated with supportive management. Three patients expired due to associated sepsis and respiratory failure, whereas others recovered with a mean hospital stay of 9 days. No long term sequelae were observed. CONCLUSION: FES remains a clinical challenge and is a diagnosis of exclusion based only on clinical grounds because of the absence of any specific laboratory test. A high index of suspicion is required for diagnosis and initiating supportive management in patients with traumatic fractures, especially in those having undergone an invasive orthopedic procedure. |
format | Online Article Text |
id | pubmed-3669567 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-36695672013-06-05 Fat embolism syndrome in long bone trauma following vehicular accidents: Experience from a tertiary care hospital in north India Koul, Parvaiz A. Ahmad, Feroze Gurcoo, Showkat A. Khan, Umar H. Naqash, Imtiyaz A. Sidiq, Suhail Jan, Rafi Ahmad Koul, Ajaz N. Ashraf, Mohammad Bhat, Mubasher Ahmad Lung India Original Article BACKGROUND: Fat embolism syndrome (FES) is a clinical problem arising mainly due to fractures particularly of long bones and pelvis. Not much literature is available about FES from the Indian subcontinent. MATERIALS AND METHODS: Thirty-five patients referred/admitted prospectively over a 3-year period for suspected FES to a north Indian tertiary care center and satisfying the clinical criteria proposed by Gurd and Wilson, and Schonfeld were included in the study. Clinical features, risk factors, complications, response to treatment and any sequelae were recorded. RESULTS: The patients (all male) presented with acute onset breathlessness, 36-120 hours following major bone trauma due to vehicular accidents. Associated features included features of cerebral dysfunction (n = 24, 69%), petechial rash (14%), tachycardia (94%) and fever (46%). Hypoxemia was demonstrable in 80% cases, thrombocytopenia in 91%, anemia in 94% and hypoalbuminemia in 59%. Bilateral alveolar infiltrates were seen on chest radiography in 28 patients and there was evidence of bilateral ground glass appearance in 5 patients on CT. Eleven patients required ventilatory assistance whereas others were treated with supportive management. Three patients expired due to associated sepsis and respiratory failure, whereas others recovered with a mean hospital stay of 9 days. No long term sequelae were observed. CONCLUSION: FES remains a clinical challenge and is a diagnosis of exclusion based only on clinical grounds because of the absence of any specific laboratory test. A high index of suspicion is required for diagnosis and initiating supportive management in patients with traumatic fractures, especially in those having undergone an invasive orthopedic procedure. Medknow Publications & Media Pvt Ltd 2013 /pmc/articles/PMC3669567/ /pubmed/23741088 http://dx.doi.org/10.4103/0970-2113.110413 Text en Copyright: © Lung India http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Koul, Parvaiz A. Ahmad, Feroze Gurcoo, Showkat A. Khan, Umar H. Naqash, Imtiyaz A. Sidiq, Suhail Jan, Rafi Ahmad Koul, Ajaz N. Ashraf, Mohammad Bhat, Mubasher Ahmad Fat embolism syndrome in long bone trauma following vehicular accidents: Experience from a tertiary care hospital in north India |
title | Fat embolism syndrome in long bone trauma following vehicular accidents: Experience from a tertiary care hospital in north India |
title_full | Fat embolism syndrome in long bone trauma following vehicular accidents: Experience from a tertiary care hospital in north India |
title_fullStr | Fat embolism syndrome in long bone trauma following vehicular accidents: Experience from a tertiary care hospital in north India |
title_full_unstemmed | Fat embolism syndrome in long bone trauma following vehicular accidents: Experience from a tertiary care hospital in north India |
title_short | Fat embolism syndrome in long bone trauma following vehicular accidents: Experience from a tertiary care hospital in north India |
title_sort | fat embolism syndrome in long bone trauma following vehicular accidents: experience from a tertiary care hospital in north india |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3669567/ https://www.ncbi.nlm.nih.gov/pubmed/23741088 http://dx.doi.org/10.4103/0970-2113.110413 |
work_keys_str_mv | AT koulparvaiza fatembolismsyndromeinlongbonetraumafollowingvehicularaccidentsexperiencefromatertiarycarehospitalinnorthindia AT ahmadferoze fatembolismsyndromeinlongbonetraumafollowingvehicularaccidentsexperiencefromatertiarycarehospitalinnorthindia AT gurcooshowkata fatembolismsyndromeinlongbonetraumafollowingvehicularaccidentsexperiencefromatertiarycarehospitalinnorthindia AT khanumarh fatembolismsyndromeinlongbonetraumafollowingvehicularaccidentsexperiencefromatertiarycarehospitalinnorthindia AT naqashimtiyaza fatembolismsyndromeinlongbonetraumafollowingvehicularaccidentsexperiencefromatertiarycarehospitalinnorthindia AT sidiqsuhail fatembolismsyndromeinlongbonetraumafollowingvehicularaccidentsexperiencefromatertiarycarehospitalinnorthindia AT janrafiahmad fatembolismsyndromeinlongbonetraumafollowingvehicularaccidentsexperiencefromatertiarycarehospitalinnorthindia AT koulajazn fatembolismsyndromeinlongbonetraumafollowingvehicularaccidentsexperiencefromatertiarycarehospitalinnorthindia AT ashrafmohammad fatembolismsyndromeinlongbonetraumafollowingvehicularaccidentsexperiencefromatertiarycarehospitalinnorthindia AT bhatmubasherahmad fatembolismsyndromeinlongbonetraumafollowingvehicularaccidentsexperiencefromatertiarycarehospitalinnorthindia |