Ozyurt Yaman, Erkal Hakan, Ozay Kemal, Arikan Zuhal
Department of Anestesiology and Reanimation, Umut Hospital, 34736 Kartal, Istanbul, Turkey.
Ulus Travma Acil Cerrahi Derg. 2006 Jul;12(3):254-7.
Fat embolism syndrome (FES) is a known complication of traumatology, especially in long bone fractures. Fat embolic events are most often clinically insignificant and difficult to recognize since clinical manifestations are varied and there is no routine laboratory or radiographic diagnostic tool. Classically, FES presents with the triad of pulmonary distress, mental status changes, and petechial rash 24 to 48 hours after long-bone fracture. We report the intensive care management of a 16-year-old female patient who developed traumatic fat embolism syndrome. Traumatic fat embolism was diagnosed, based on suggestive clinical manifestations, radiographic and laboratory findings and confirmed by the demonstration of arterial hypoxemia in the absence of other disorders. Admission to the intensive care unit, mechanical ventilatory support with positive end-expiratory pressure and supportive therapy leaded to the patient's improvement and she was discharged with planned open reduction and internal fixation.
脂肪栓塞综合征(FES)是创伤学中一种已知的并发症,尤其是在长骨骨折中。脂肪栓塞事件在临床上大多无显著意义且难以识别,因为其临床表现多样,并且没有常规的实验室或影像学诊断工具。典型的脂肪栓塞综合征在长骨骨折后24至48小时出现肺部窘迫、精神状态改变和瘀点疹三联征。我们报告了一名16岁女性创伤性脂肪栓塞综合征患者的重症监护管理情况。根据提示性的临床表现、影像学和实验室检查结果诊断为创伤性脂肪栓塞,且在排除其他疾病的情况下通过动脉血氧不足的证实得以确诊。入住重症监护病房、采用呼气末正压进行机械通气支持以及支持性治疗使患者病情好转,她在计划进行切开复位内固定后出院。