Patrick F Allan1, Darius K Amjadi, Ralph L Haynes. 1. Department of Pulmonary, Critical Care, and Sleep Medicine Landstuhl Regional Medical Center, CMR 402, Box 307, APO AE 09180, Landstuhl, Germany.
Abstract
OBJECTIVE: Fat emboli syndrome (FES) is a disorder associated with both acute lung injury and acute respiratory distress syndrome. Both FES and diffuse alveolar hemorrhage (DAH) are bronchoscopically definable entities that may share a common etiology. We conducted a chart review analysis to examine the relationship between FES and DAH. METHODS: Retrospective chart review. RESULTS: Three cases of concurrent FES and DAH were identified. Long bone fracture and/or orthopedic procedures preceded all the events and were the likely inciting source for eventual acute lung injury. Bronchoalveolar lavage-evident DAH and FES was found in all these cases in association with hemoptysis and lung-attributed blood loss. Lung-protective ventilation and standard supportive care approaches proved sufficient in attaining good outcomes. CONCLUSION: Combined FES and DAH can occur in association with orthopedic injury and repair and are likely an under-recognized entity.
OBJECTIVE: Fat emboli syndrome (FES) is a disorder associated with both acute lung injury and acute respiratory distress syndrome. Both FES and diffuse alveolar hemorrhage (DAH) are bronchoscopically definable entities that may share a common etiology. We conducted a chart review analysis to examine the relationship between FES and DAH. METHODS: Retrospective chart review. RESULTS: Three cases of concurrent FES and DAH were identified. Long bone fracture and/or orthopedic procedures preceded all the events and were the likely inciting source for eventual acute lung injury. Bronchoalveolar lavage-evident DAH and FES was found in all these cases in association with hemoptysis and lung-attributed blood loss. Lung-protective ventilation and standard supportive care approaches proved sufficient in attaining good outcomes. CONCLUSION: Combined FES and DAH can occur in association with orthopedic injury and repair and are likely an under-recognized entity.