Richa Aggarwal,Arnab Banerjee,Kapil dev Soni,Atin Kumar,Anjan Trikha.[J].中华创伤杂志英文版,2019,22(3):172-176
Clinical characteristics and management of patients with fat embolism syndromein level I Apex Trauma Centre
  
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KeyWord: Fat embolismTrauma centersIntensive care unitsPatient outcome assessment
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Author NameAffiliation
Richa Aggarwal Critical and Intensive Care, JPNATC, All India Institute of Medical Sciences, New Delhi, India 
Arnab Banerjee Department of Plastic Surgery, All India Institute of Medical Sciences, New Delhi, India 
Kapil dev Soni Critical and Intensive Care, JPNATC, All India Institute of Medical Sciences, New Delhi, India 
Atin Kumar Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India 
Anjan Trikha Department of Anesthesiology, Critical Care and Pain Medicine, All India Institute of Medical Sciences, New Delhi, India 
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Abstract:
      Purpose: Fat embolism syndrome (FES) is systemic manifestation of fat emboli in the circulation seen mostly after long bone fractures. FES is considered a lethal complication of trauma. There are various case reports and series describing FES. Here we describe the clinical characteristics, management in ICU and outcome of these patients in level I trauma center in a span of 6 months. Methods: In this prospective study, analysis of all the patients with FES admitted in our polytrauma intensive care unit (ICU) of level I trauma center over a period of 6 months (from August 2017 to January 2018) was done. Demographic data, clinical features, management in ICU and outcome were analyzed. Results: We admitted 10 cases of FES. The mean age of patients was 31.2 years. The mean duration from time of injury to onset of symptoms was 56 h. All patients presented with hypoxemia and petechiae but central nervous system symptoms were present in 70% of patients. The mean duration of mechanical ventilation was 11.7 days and the mean length of ICU stay was 14.7 days. There was excellent recovery among patients with no neurological deficit. Conclusion: FES is considered a lethal complication of trauma but timely management can result in favorable outcome. FES can occur even after fixation of the fracture. Hypoxia is the most common and earliest feature of FES followed by CNS manifestations. Any patient presenting with such symptoms should raise the suspicion of FES and mandate early ICU referral.
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