Any injury is a huge damage to the health of our body. However, it often happens that the trauma itself may be non-lethal, but its complications lead to an imminent death. One of such complications is fat embolism.
Features of the disease
Fat embolism is a pathological process, due to the fact that fats get into the blood. Most often, the pathology manifests itself against the background of injuries, especially in patients with large blood loss and excessive body weight.
It is noted that the frequency of fat embolism increases, if postponed surgery, about 5 times.
Forms
In medical practice, three forms of the disease are distinguished depending on its course:
- Lightning fast. Develops and leads to death in a few minutes.
- Sharp. It develops within a few hours after traumatization.
- Subacute. Develops within 12-72 h.
Classification of
Conditional classification divides fat embolus into pulmonary, cerebral and mixed. On the location of the lesion, the pathology is divided into fat embolism:
- of the brain;
- of the lungs;
- of the liver;
- is less common than other organs;
Depending on the reasons, you can divide fat embolism into what happens when or after amputation, fractures, surgery, taking certain groups of drugs.
Causes of
Today, doctors adhere to two theories regarding the causes of fat embolism, mechanical and biochemical.
- The first theory is that embolism develops with increased pressure in the bone marrow during a trauma or surgery. Recent actions lead to the penetration of fat cells into the blood, where they form microthrombi, which by blood moves to the organs.
- Biochemical theory says that the traumatization of cells is accompanied by a hormonal change. Hormonal changes can be combined with sepsis, which causes the penetration of lipoproteins into the blood. Lipoproteins cling to the vessels of the lungs, which damages them and leads to a violation of blood circulation.
The main cause of fat embolism is trauma and surgical intervention on tubular bones. Less common pathology manifests itself in the background:
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The opinion of doctors. .. & gt; & gt;
- of hip joint prosthetics;
- closed repository of bone fractures;
- intramedullary osteosynthesis of the femur;
- liposuction;
- major burns;
- extensive injuries of soft tissues;
- bone marrow biopsy;
- of osteomyelitis;
- of acute pancreatitis;
- of fatty liver disease;
For more information on what is the vascular embolism, see the video below:
Symptoms and signs of fat embolism
Fat embolism is dangerous because it can be asymptomatic in the first 2-3 days. In this case, there is a general deterioration in the condition, which the patient takes for granted after surgery or trauma. Developing, pathology is manifested in:
- heartbeat;
- rapid breathing;
- petechiae, that is, in small red spots appearing at the sites of small vessel bleeding;
- confusion;
- fever;
A patient with fat embolism syndrome feels very tired, headaches and chest pains and dizziness may occur.
We will talk about the difficulties of diagnosing fat embolism further.
Diagnostics
Primary diagnosis is reduced to the analysis of anamnesis of the signs of the disease. The patient has CNS disorders, fever and other signs, up to coma.
Diagnosis is confirmed with:
- Common urine and blood anodes showing the general condition of the patient, the presence of concomitant diseases.
- Biochem.en-for blood, revealing possible causes, unrelated to trauma.
- CT of the skull, excluding intracranial changes.
- Radiography, excluding pneumothorax.
The most accurate study is MRI, which allows you to visualize the organ and determine the cause of the embolism.
On the treatment of fat embolism in fractures and other causes, we tell further.
Treatment
Please note! Folk remedies fatty embolism is not treated! It is forbidden to resort to non-traditional medicine, as it is guaranteed to lead to death.
Therapeutic
As a therapeutic technique, oxygen therapy through nasal catheters is first used. However, it often proves to be ineffective, especially if the pathology has not been detected immediately.
After it, respiratory therapy is carried out with the maintenance of PaO2 greater than 70-80 mmHg. Art.and SrO2 within 90-98%.
Medication
The treatment program may vary depending on the methods used in the hospital setting. Standard treatment begins with:
- Sedative therapy, which can be combined with artificial ventilation of the lungs, appointed with the appearance of severe cerebral disorders.
- Analgesics for lowering temperature.
- Antibiotics of a wide spectrum.
- Corticosteroids, for example, methylprednisolone or prednisolone. Their effectiveness is not proven, but many doctors believe that these drugs prevent the development of the process.
To stabilize the patient's condition use a solution of 9% sodium chloride, Ringer or albumin. To reduce the accumulation of fluid in the lungs can be prescribed diuretics.
Prevention of fat embolism in fractures and other causes is discussed below.
Prevention
Preventive measures are performed in patients with risk factors, for example, those who underwent operative treatment or extensive traumatization. Prevention is reduced to:
- Rendering competent medical care for injuries.
- Elimination of hypovolemia and hemorrhage.
- Correct immobilization of the patient, for example, with pneumatic tires.
- Gentle transportation of the patient on an ambulance.
- Early disaggregant infusion therapy.
- Reception of lipotropic drugs, as well as substances that do not allow demulsification of lipids, for example, alcohol.
- Monitoring the patient.
Preventative measures last for 3-4 days after injury or surgery.
The following video will tell you about the risks of fat embolism when injected:
Complications of
Fat embolism in itself can be considered a complication, so it is dangerous initially. Even with proper treatment, it leads to blood flow disorders, which affects the entire body, exacerbating chronic diseases. The most serious complication of pathology can be considered a lethal outcome.
Fat embolism has its own prognosis.about which we will talk further.
Forecast
Earlier fatality with fat embolism reached 65%.Now the methods of diagnosis and treatment have improved, and deaths have decreased to 5-13%.
But the prognosis is still classified as unfavorable, as some forms of embolism are difficult to diagnose.