Fat embolism syndrome primary prevention: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
 
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Fat embolism syndrome}}
{{Fat embolism syndrome}}
{{CMG}} ; {{AE}}
{{CMG}} ; {{AE}} {{FT}}
==Overview==
==Overview==
Effective measurement for the primary [[Prevention (medical)|prevention]] of fat embolism include early fixation of long bone fractures, external fixation with a plate and screw and use of small-diameter nails.  
Effective measurement for the primary [[Prevention (medical)|prevention]] of fat embolism include early fixation of long bone fractures, external fixation with a plate and screw and use of small-diameter nails.  

Latest revision as of 03:56, 6 April 2018

Fat embolism syndrome Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Fat embolism syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Fat embolism syndrome primary prevention On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Fat embolism syndrome primary prevention

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Fat embolism syndrome primary prevention

CDC on Fat embolism syndrome primary prevention

Fat embolism syndrome primary prevention in the news

Blogs on Fat embolism syndrome primary prevention

Directions to Hospitals Treating Fat embolism syndrome

Risk calculators and risk factors for Fat embolism syndrome primary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Overview

Effective measurement for the primary prevention of fat embolism include early fixation of long bone fractures, external fixation with a plate and screw and use of small-diameter nails.

Primary Prevention

Effective measurement for the primary prevention of fat embolism are as follows:[1]

Pre-operative preventive measures:

  • Preoperative intravenous injection of dexamethasone.[2]
  • Continuous pulse oximetry to detect hypoxemia at early stages.[3][4][5]
  • Early fixation of long-bone fracture.
  • External fixation or fixation with plate and screw decreases the possibility of fat embolism than than nailing the medullary cavity and venting the medullary canal during nailing.[4]
  • If nails are needed, smaller-diameter nails and unreamed nailing may be better.[6]

In-operation preventive measures:

In patients having surgery for long bone fractures following preventive measures should be taken:

  • Early detection of the symptoms by careful vigilence and high degree of clinical suspicion.
  • Continuous monitoring for the fall in oxygen saturation.
  • An early initiation of supplemental oxygen and steroids may help in inhibiting the hypoxic insult and manifestations of full-blown FES.
  • The patient should not be over sedated.
  • Careful monitroing of vitals and temperature is mandatory.
  • Periodic neurological assessment.
  • Albumin should be used for volume resuscitation as it binds with free fatty acids and reduces lung injury.

References

  1. Jiang J, Wang H, Wang Y (2010). "[Clinical study on effect of dexamethasone in preventing fat embolism syndrome after cemented hip arthroplasty]". Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 24 (8): 913–6. PMID 20839434.
  2. Cavallazzi R, Cavallazzi AC (2008). "[The effect of corticosteroids on the prevention of fat embolism syndrome after long bone fracture of the lower limbs: a systematic review and meta-analysis]". J Bras Pneumol. 34 (1): 34–41. PMID 18278374.
  3. Wong MW, Tsui HF, Yung SH, Chan KM, Cheng JC (2004). "Continuous pulse oximeter monitoring for inapparent hypoxemia after long bone fractures". J Trauma. 56 (2): 356–62. doi:10.1097/01.TA.0000064450.02273.9B. PMID 14960980.
  4. 4.0 4.1 Schmidt J, Sulk C, Weigand C, La Rosée K, Schneider T (2001). "[Preventing fat embolism syndrome (FES) in implantation of cemented hip endoprosthesis shafts with a trans-prosthetic drainage system (TDS)]". Biomed Tech (Berl). 46 (11): 320–4. PMID 11778316.
  5. Schonfeld SA, Ploysongsang Y, DiLisio R, Crissman JD, Miller E, Hammerschmidt DE; et al. (1983). "Fat embolism prophylaxis with corticosteroids. A prospective study in high-risk patients". Ann Intern Med. 99 (4): 438–43. PMID 6354030.
  6. Pitto RP, Kössler M, Draenert K (1998). "[Prevention of fat and bone marrow embolism in cemented total hip endoprosthesis with vacuum cement technique]". Z Orthop Ihre Grenzgeb. 136 (4): Oa24. PMID 9795426.