Fat embolism

Adipose embolism most often occurs in fractures involving significant destruction of bone marrow bones. The fat is mixed with blood, educated hematoma between the fragments, hence drop it can penetrate into the damaged bone gaping veins. Lack of fracture immobilization facilitates entry of fat in the lumen of blood vessels, and the suction effect of the chest during inspiration — his further advancement in the bloodstream. Transfer of fat droplets through the blood circulation increases in the amplification of the latter (for example, as a result of blood transfusion). This explains how the "free period" between the injury and the onset of clinical signs of embolism, and the possibility of re-admission of fat in the blood vessels and the new sudden deterioration in already developed pictures embolism.
Fat embolism may also cause bone surgery, particularly fixation (see) by intraosseous fixation. Sometimes a fat embolism is a serious injury of soft tissue (pelvic tissue, liver) with no damage to bones, as well as erroneous intravenous oily liquids (such as camphor oil).
Two forms of adipose embolism — pulmonary and cerebral. In pulmonary (respiratory) form multiple small vessel occlusion of the pulmonary circulation appears sudden shortness of breath, coughing, cyanosis, quickens the pulse, blood pressure drops. Embolism larger branches of the pulmonary trunk develops a picture of severe cardiopulmonary diseases, threatening death. The danger increases if embolism cause a reflex spasm of the entire system of the pulmonary trunk or the coronary arteries. In the latter case, the possibility of sudden death with symptoms of angina. Massive fat embolism may be accompanied by the formation of petechiae and small bruises on the face, neck, chest, conjunctiva and sclera, in the mouth, etc., as well as the appearance of fat in the urine (late sign).
Fat about the past of the small circle in the large and trapped in the brain, causing cerebral form adipose embolism. The pushing of the pulmonary emboli vessel into a large circle contribute Treading blood pressure (coming out of shock, excessive parenteral fluid administration) and cough shock. Consequently, the cerebral form develops in the lung, although the latter may not clinically manifest (when hit small amounts of fat.) Only with cleft PFO oil can get into the systemic circulation, bypassing the blood vessels of the lungs. Signs of cerebral fat embolism are loss of consciousness, convulsions, paralysis of limbs, the appearance of pathological reflexes. A quick death. Adipose emboli passing into the left heart may obturate coronary vessels and cause a severe heart attack.

  • Treatment
  • Prophylaxis

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