Newbigin Katrina, Souza Carolina A, Torres Carlos, Marchiori Edson, Gupta Ashish, Inacio Joao, Armstrong Mitchel, Peña Elena
Wesley Hospital, Brisbane, Australia.
The Ottawa Hospital, Ottawa, Ontario, Canada.
Respir Med. 2016 Apr;113:93-100. doi: 10.1016/j.rmed.2016.01.018. Epub 2016 Feb 1.
Fat embolism syndrome (FES) is a rare but potentially fatal complication of trauma or orthopedic surgery, which presents predominantly with pulmonary symptoms. Modern intensive care has improved the mortality rates, however diagnosis remains difficult, relying predominantly on a combination of a classic triad of symptoms and non-specific, but characteristic radiological features. The aim of this review is to describe the main clinical and imaging aspects of FES, ranging from pathophysiology to treatment with emphasis on pulmonary involvement.
We reviewed the currently published literature on the main characteristics of FES.
In a hypoxic patient with recent trauma or orthopedic surgery, the presence of diffuse, well-demarcated ground glass opacities or ill-defined centrilobular nodules on computed tomography (CT) of the chest are suggestive of FES.
Combination of the classic clinical syndrome in the appropriate clinical setting, together with the characteristic imaging findings on chest CT, can help to achieve the correct diagnosis. Management remains predominantly supportive care, and the benefit of medical therapies such as corticosteroids and heparin remains unclear.
脂肪栓塞综合征（FES）是创伤或骨科手术中一种罕见但可能致命的并发症，主要表现为肺部症状。现代重症监护已降低了死亡率，然而诊断仍然困难，主要依赖经典三联征症状和非特异性但具有特征性的放射学特征的组合。本综述的目的是描述FES的主要临床和影像学方面，从病理生理学到治疗，重点是肺部受累情况。
我们回顾了目前已发表的关于FES主要特征的文献。
在近期有创伤或骨科手术史的低氧患者中，胸部计算机断层扫描（CT）上出现弥漫性、边界清晰的磨玻璃影或边界不清的小叶中心结节提示FES。
在适当的临床背景下，经典临床综合征与胸部CT上的特征性影像学表现相结合，有助于做出正确诊断。治疗仍主要是支持性治疗，皮质类固醇和肝素等药物治疗的益处尚不清楚。
