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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...

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Autores principales: 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
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
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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.
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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
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