Seifert S A, Dart R C, Kaplan E H
Rocky Mountain Poison and Drug Center, Denver, Colorado 80220-6800, USA.
J Toxicol Clin Toxicol. 1998;36(7):733-6. doi: 10.3109/15563659809162624.
To describe a case of fat embolus syndrome with lipoid pneumonia resulting from intravenous infusion of lipid and to illustrate the potential for accidental intravenous administration of vegetable oil-based progesterone preparations in the treatment of oncology patients.
A patient with recurrent ovarian carcinoma accidentally received approximately 20 mL (0.29 mL/kg) of a peanut oil-based methylprogesterone product intravenously via infusion pump over 24 hours. The patient developed a lipoid pneumonia with dyspnea, cough, hypoxia, radiographic infiltrates, and a pleural effusion. She was hospitalized for 4 days, and signs and symptoms resolved over 2 weeks following steroids and supportive care.
Experience with accidental or intentional intravenous lipid overdose in humans is limited. Typical findings of fat embolus syndrome are similar to lipid aspiration, with respiratory distress, hypoxia, and pulmonary infiltrates. In contrast to aspiration, however, fat embolus syndrome results in lipogranulomas surrounding blood vessels, rather than air passages, and potentially produces cerebrovascular, accident-like symptoms. Management of fat embolus syndrome is similar to that for lipid aspiration. However, as seen in this case, fat embolus syndrome typically resolves over several weeks as opposed to the 3-month to 1-year period seen with aspiration lipoid pneumonias.
Accidental intravenous infusion of vegetable oil-based products is a potential complication of the increased use of intravenous progesterones.
描述一例因静脉输注脂质导致脂肪栓塞综合征合并类脂性肺炎的病例，并说明在肿瘤患者治疗中意外静脉注射植物油基孕酮制剂的可能性。
一名复发性卵巢癌患者在24小时内通过输液泵意外静脉输注了约20毫升（0.29毫升/千克）花生油基甲孕酮产品。患者出现类脂性肺炎，伴有呼吸困难、咳嗽、缺氧、影像学浸润和胸腔积液。她住院4天，在接受类固醇治疗和支持治疗后，症状体征在2周内消退。
人类意外或故意静脉内脂质过量的经验有限。脂肪栓塞综合征的典型表现与脂质吸入相似，有呼吸窘迫、缺氧和肺部浸润。然而，与吸入不同的是，脂肪栓塞综合征导致血管周围出现脂肪肉芽肿，而非气道周围，并可能产生类似脑血管意外的症状。脂肪栓塞综合征的治疗与脂质吸入的治疗相似。然而，如本病例所示，脂肪栓塞综合征通常在数周内消退，而吸入性类脂性肺炎则需要3个月至1年的时间。
意外静脉输注植物油基产品是静脉使用孕酮增加的一种潜在并发症。
