The Experience Of Diagnosis, Treatment And Review For Fat Embolism Syndrome

Background Fat embolism syndrome (FES) has typical triad signs including dyspnea, central nervous system function and skin ecchymosis.. Various causes result in lipids from bone marrow or other tissues to enter into the blood vessel, which embolize lung, brain and skin. FES is very easy to be misdiagnosed or missed diagnosis in the early phase for acute onset, rapid progression and complicated clinical manifestations. Therefore, the state and prognosis of an illness usually are delayed and influenced.Objective To investigate the clinical characteristics and effect of diagnosis and therapy on fat embolism syndrome (FES) and review.Methods The etiology, clinical manifestation, laboratory and radiological characteristics, diagnosis, treatment and outcome of 11 patients with FES during 2004 to 2014 were retrospectively analyzed.Results There were 9 cases for traumatic long bone fracture,2 cases for artificial knee joint replacement in 11 patients. There were 10 cases for disturbance of consciousness,1 case for dyspnea and 3 cases for petechia of skin in the first onset. There were 2 cases for "snow storm appearance" in chest X-ray,8 cases for abnormality in pulmonary CT and 3 cases for multiple cerebral infarction in MRI. The rates of final diagnosis and misdiagnosis within 72h were 63.63% and 36.36%, respectively.7 cases were cured,1 case was vegetative state and 3 cases died. The mortality rate of FES was about 27.2%Conclusions The main causes of FES include traumatic long bone fracture and operation of joint. The early definite diagnosis in early stage and effective combined modality therapy are key point of successful therapy.