Cerebral Fat Embolism: An indication for ICP monitor?

Sie, M Y; Toh, Keita; Rajeev, Kishen

doi:10.1097/01.ta.0000100833.57027.1f

Cited by 7 publications

(5 citation statements)

References 5 publications

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“…Patients with FES may develop cerebral oedema, leading to rapid deterioration. In such cases, ICP monitoring may be beneficial and should be considered (Sie et al, 2003). In general, trauma patients should not have their neurological examination obscured by excessive sedation or NMBAs in order to allow them to tolerate mechanical ventilation.…”

Section: Treatmentmentioning

confidence: 99%

Fat embolism syndrome: What have we learned over the years?

Tzioupis

Giannoudis

2011

Trauma

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Although its original clinical description dates from the nineteenth century, fat embolism syndrome remains a diagnostic challenge for clinicians. Fat emboli occur in all patients with long-bone fractures, but only few of them develop a multisystem disorder affecting the lung, brain, and skin, also known as fat embolism syndrome (FES). The incidence of FES varies and is often underestimated. Mechanical and biochemical theories have been proposed for the pathophysiology of FES. Clinical manifestations consist of respiratory and cerebral dysfunction and a petechial rash. Diagnosis of FES is difficult and based mainly on clinical criteria. FES is a self-limiting disease and treatment needs to be mainly supportive. Surgical treatment of the coexistent injuries is still obscured by controversies and the treatment methods used provide inconclusive results. In this context, prevention focuses on the early identification of predisposing factors.

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Section: Treatmentmentioning

confidence: 99%

Fat embolism syndrome: What have we learned over the years?

Tzioupis

Giannoudis

2011

Trauma

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“…[20] Patients with FES and cerebral edema may benefit from placement of an intracranial pressure monitor in order to direct treatment of cerebral edema. [37]…”

Section: Treatmentmentioning

confidence: 99%

Fat embolism syndrome

Kwiatt

Seamon

2013

Int J Crit Illn Inj Sci

103

117

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Fat embolism syndrome (FES) is an ill-defined clinical entity that arises from the systemic manifestations of fat emboli within the microcirculation. Embolized fat within capillary beds cause direct tissue damage as well as induce a systemic inflammatory response resulting in pulmonary, cutaneous, neurological, and retinal symptoms. This is most commonly seen following orthopedic trauma; however, patients with many clinical conditions including bone marrow transplant, pancreatitis, and following liposuction. No definitive diagnostic criteria or tests have been developed, making the diagnosis of FES difficult. While treatment for FES is largely supportive, early operative fixation of long bone fractures decreases the likelihood of a patient developing FES.

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“…It is paramount that patients of CFES with long bone fracture receive fluid resuscitation, airway ventilation, and early fixation within 24 h. ICP monitoring is also beneficial [7]. Albumin binding to oleic acid can decrease the cytotoxic effect of fatty acid.…”

Section: Discussionmentioning

confidence: 99%

Favorable Outcome of Cerebral Fat Embolism Syndrome with a Glasgow Coma Scale of 3: a Case Report and Review of the Literature

et al. 2014

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Prognosis of deep coma caused by cerebral fat embolism syndrome (CFES) is rarely reported. We present a case of fulminant CFES which was induced by long bone fracture, with a Glasgow Coma Scale (GCS) of 3/15. The brain magnetic resonance imaging (MRI) revealed abnormal spotty lesions scattered over both cerebral hemispheres and the posterior fossa. Thirty days later, the patient regained consciousness with a GCS of 15/15.

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Cerebral Fat Embolism: An indication for ICP monitor?

Cited by 7 publications

References 5 publications

Fat embolism syndrome: What have we learned over the years?

Fat embolism syndrome: What have we learned over the years?

Fat embolism syndrome

Favorable Outcome of Cerebral Fat Embolism Syndrome with a Glasgow Coma Scale of 3: a Case Report and Review of the Literature

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