Ashish Nair Senior Resident, Department of Anesthesiology, Critical Care Medicine, Bharti Vidyapeeth Hospital, Pune 411043, Maharashtra, India
Athira CN Resident, Department of Critical Care Medicine, Bharti Vidyapeeth Hospital, Pune 411043, Maharashtra, India
Prashant P Jedge Associate Professor, Department of Anesthesiology, Critical Care Medicine, Bharti Vidyapeeth Hospital, Pune 411043, Maharashtra, India
Address for correspondence: Athira CN, Resident, Department of Critical Care Medicine, Bharti Vidyapeeth Hospital, Pune 411043, Maharashtra, India E-mail: drathiracn@gmail.com
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Nair A, Athira CN, Jedge PP. Detect it early! Fat embolism syndrome (FES). Ind J Anesth Analg. 2024;11(2):87-94.
Timeline
Received : January 09, 2024
Accepted : February 20, 2024
Published : June 29, 2024
Abstract
Fat embolism syndrome (FES) is a rare but a serious clinical catastrophe occurring after traumatic injury to long bones. Cerebral involvement in the absence of pulmonary or dermatological manifestation on initial presentation may delay the diagnosis of cerebral fat embolism (CFE). Cerebral fat embolism typically occurs in patients with bony fractures (usually long bones of the lower limb). Fat embolism syndrome has an incidence of 1-3% following long bone fractures and 33% in patients with bilateral long bone fractures. We discuss a case series of CFE which posed a challenge in diagnosis. The clinical presentations of these patients did not satisfy the commonly used clinical criteria for aiding the diagnosis of FES. Early MRI brain (DWI and T2 weighted sequences) in patients with neurological symptoms after trauma even in the absence of pulmonary and dermatological findings should be the goal.
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Nair A, Athira CN, Jedge PP. Detect it early! Fat embolism syndrome (FES). Ind J Anesth Analg. 2024;11(2):87-94.
This license enables reusers to distribute, remix, adapt,
and build upon the material in any medium or format for noncommercial purposes
only, and only so long as attribution is given to the creator.
This license enables reusers to distribute, remix, adapt,
and build upon the material in any medium or format for noncommercial purposes
only, and only so long as attribution is given to the creator.
Description: Pathogenesis of fat embolism. Three thenries have been proposed: mechanical, coagulation, and biochemical. Fat embolisation causes local parenchymal damage after vascular occlusion (by fat or thrombus), an exaggerated inflammatory response, or both. Subsequently, pulmonary haemorrhage, consolidation, pulmonary oedema and/or alveolar collapse result in a ventilation (V)/ perfusion (Q) mismatch and hypoxaemia. CRP, C-reactive protein
Petechial rash seen over the chest and axilla
Description: No description available.
Hyperintensities seen diffusely in bilateral cerebral hemispheres
Description: No description available.
Hyperintensities seen diffusely in bilateral cerebral hemispheres of diffusion susceptibility imaging
Description: No description available.
Hyperintensities seen diffusely in bilateral cerebral hemispheres of diffusion susceptibility imaging