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synonyms:
Fat Embolism Syndrome ICD-10
Fat Embolism Syndrome ICD-9
Fat Embolism Syndrome Etiology / Epidemiology / Natural History
- seen in young people with leg fractures sustained in vehicular accidents and elderly people with hip fractures or after arthroplasty
- Sixty percent of all cases of FES are seen in the first 24 hours after trauma, and 90% of all cases appear within 72 hours
Fat Embolism Syndrome Anatomy
Fat Embolism Syndrome Clinical Evaluation
- Classic triad of hypoxia, confusion, and petechiae appearing in a patient with fractures usually occurs within 48 hours of injury.
- Respiratory symptoms: cough, dyspnea, hemoptysis, and pleural pain;.
- Signs include pyrexia, tachycardia, tachypnea, rales rhonchi, and friction rub.
- CNS symptoms: confusion, restlessness, stupor, delirium
- Skin symptoms: petechiae along the anterior axillary folds and in the conjunctiva and retina.
- Gurd and Wilson’s criteria
- Major signs are respiratory insufficiency, cerebral involvement, and petechial rash.
- Minor signs are fever, tachycardia, retinal changes, jaundice, and renal changes.
- The diagnosis of FES is made when one major and four minor signs are present.
- Labs: increase in the A-a O2 gradient, and V/Q inequality, PO2 less than 60 mmHg on room air.
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Fat Embolism Syndrome Xray / Diagnositc Tests
- Chest X-Rays are often normal or may show an ARDS picture 1-2 days after trauma.
Fat Embolism Syndrome Classification / Treatment
- Ventilatory support is the treatment of choice
- surgical stabilization of long bone fractures is beneficial
- the use of steroids, heparin, or low-molecular weight dextran has not been associated with improved clinical results in any prospective clinical trials
Fat Embolism Syndrome Associated Injuries / Differential Diagnosis
Fat Embolism Syndrome Complications
Fat Embolism Syndrome Follow-up Care
Fat Embolism Syndrome Review References
- Gossling HR, Donohue TA: The fat embolism syndrome. JAMA 1979;241:2740-2742.
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