Fat embolism syndrome is usually being described as respiratory failure secondary to embolization of fat macroglobules to the lung circulationg causing endothelial damage in capillary beds hence giving ARDS feature.
It is usually occur 48-72 hours of injury especially of the long bone fracture. However, other etiology has been established apart from the long bone trauma such as Blood transfusion, Burns, Cardiopulmonary bypass, Collagen disease, Decompression from altitude, Diabetes mellitus, Hemoglobinopathy, Infections, Medullary reaming, Multiple trauma, Neoplasm, Osteomyelitis, Renal transplantation, Suction lipectomy, acute pancreatitis and post total hip replacement surgery.
Fat embolism syndrome was firstly described by Von Bergmann in 1873 after observed the syndrome that occur in a patient with broken femur.
The most accepted guideline for diagnosis of fat embolism syndrome is by Gurd and Wilson which require at least one major criteria or four minor criteria.
Reference:
James L. Glazer and Daniel K. Onion, "Fat Embolism Syndrome in a Surgical Patient", JABFP July–August 2001 Vol. 14 No. 4
Thank you for making all your work public: very useful, very concise.
ReplyDeleteOne question, does Gurd require 1 major OR 4 minor (in which case it would seem fairly non-specific) or 1 major AND 4 minor (in which case it would seem non-sensitive)