Allan Patrick F, Amjadi Darius K, Haynes Ralph L
Department of Pulmonary, Critical Care, and Sleep Medicine Landstuhl Regional Medical Center, CMR 402, Box 307, APO AE 09180, Landstuhl, Germany.
Mil Med. 2011 Sep;176(9):1071-6. doi: 10.7205/milmed-d-10-00432.
Fat emboli syndrome (FES) is a disorder associated with both acute lung injury and acute respiratory distress syndrome. Both FES and diffuse alveolar hemorrhage (DAH) are bronchoscopically definable entities that may share a common etiology. We conducted a chart review analysis to examine the relationship between FES and DAH.
Retrospective chart review.
Three cases of concurrent FES and DAH were identified. Long bone fracture and/or orthopedic procedures preceded all the events and were the likely inciting source for eventual acute lung injury. Bronchoalveolar lavage-evident DAH and FES was found in all these cases in association with hemoptysis and lung-attributed blood loss. Lung-protective ventilation and standard supportive care approaches proved sufficient in attaining good outcomes.
Combined FES and DAH can occur in association with orthopedic injury and repair and are likely an under-recognized entity.
脂肪栓塞综合征（FES）是一种与急性肺损伤和急性呼吸窘迫综合征相关的疾病。FES和弥漫性肺泡出血（DAH）都是可通过支气管镜明确诊断的疾病，可能有共同的病因。我们进行了一项病历回顾分析，以研究FES与DAH之间的关系。
回顾性病历审查。
确定了3例FES与DAH同时发生的病例。所有病例之前均有长骨骨折和/或骨科手术，这可能是最终急性肺损伤的诱发因素。在所有这些病例中均发现支气管肺泡灌洗证实的DAH和FES，并伴有咯血和肺部失血。事实证明，肺保护性通气和标准支持性护理方法足以取得良好的治疗效果。
FES与DAH合并症可能与骨科损伤和修复有关，可能是一种未被充分认识的疾病。
