FES (Fat embolism syndrome)
Incidence: highest 10-40 years, men > women3
Diagnosis: no standard diagnostic criteria exist
- Hypoxemia (the most common initial signs of FES)
- Neurologic abnormalities (typically manifest after the respiratory changes)
- Petechiae in nondependent regions (conjunctiva, head, neck, anterior thorax, or axilla)
all of which occur after an asymptomatic latent period of 24-48 hours postinjury
Fulminant cases of FES may present with right ventricular dysfunction, biventricular failure, acute respiratory distress syndrome, shock, and death.
- supportive care of the respiratory failure and hypovolemia, along with frequent monitoring of neurologic status in ICU (standard)
Latent period: 11-72 ชม.
Pathophysiology: not fully understood (OKU)
- Now: two main processes:
- mechanical obstruction
- biochemical injury
- clinical signs and symptoms of FES
- subclinical phenomenon of fat embolization (occurs frequently with long bone and pelvic fractures)