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VOLUME 17 , ISSUE 1 ( February, 2013 ) > List of Articles

RESEARCH ARTICLE

Early, reliable, utilitarian predictive factors for fat embolism syndrome in polytrauma patients

Avinash Kumar, Amit Aggarwal, Nirmal Raj Gopinathan, Vibhu K Viswanathan, Ramesh K. Sen, H. C. Mallikarjun, Sakthivel R. Rajaram Manoharan, Radheshyam Sament

Keywords : Fat embolism syndrome, polytrauma patients, pulsoximetry, serum lactate

Citation Information : Kumar A, Aggarwal A, Gopinathan NR, Viswanathan VK, Sen RK, Mallikarjun HC, Manoharan SR, Sament R. Early, reliable, utilitarian predictive factors for fat embolism syndrome in polytrauma patients. Indian J Crit Care Med 2013; 17 (1):38-42.

DOI: 10.4103/0972-5229.112155

License: CC BY-ND 3.0

Published Online: 01-02-2013

Copyright Statement:  Copyright © 2013; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Fat embolism is one of the apocalyptic pulmonary complications following high energy trauma situations. Since delay in diagnosis may have devastating consequences, early, easily accessible and relatively inexpensive investigations for risk stratification may prove useful, especially in developing nations. Materials and Methods: This prospective trial included a total of 67 young polytrauma patients, in whom the role of nine easily available, rapidly performable clinical or laboratory investigations (or observations noted at admission) in predicting the later occurrence of fat embolism syndrome were assessed. All the patients also underwent continuous monitoring of oxygen saturation with pulsoximetry. Results: The correlation between initial serum lactate (within 12 hours of injury) and hypoxia was statistically significant. There was a trend towards correlation with FES(by Gurd′s criteria) (P=0.07), Sensitivity of 24-hour monitoring of oxygen saturation in predicting later pulmonary deterioration approached 100%. Conclusions: The combination of three factors including polytrauma (with NISS >17), serum lactate >22 mmol/l at admission (within 12 hours of injury) fall in oxygen saturation (SaO 2 below 90% in the initial 24 hours) predict the development of post-traumatic pulmonary complications, especially the fat embolism syndrome.


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