Fat embolism syndrome Síndrome de embolismo graso

Abstract

Background: Patients with diaphyseal fractures of long bones with hypovolemia and hypoxia present a greater risk of fatty embolism syndrome (SEG). Early management with intravenous fluids and oxygen therapy can prevent it. The incidence in the San José hospital is 7%.
Objective: to establish the frequency of SEG in the patients who attended between February and December of 2003, with diaphyseal fractures of the femur and / or tibia, managed from the admission with intravenous fluids and oxygen.
Design: observational, retrospective and descriptive study, case series type.
Place: San José hospital (level IV).
Results: of 59 patients, 35 (58%) admitted to the emergency department in the first 60 minutes after the trauma, 26 (44%) presented a closed tibia fracture and 18 (30%) a closed femur fracture. Ten were considered polyfractured (17%) and 3 (5%) polytraumatized. 48 (81%) suffered high energy trauma. In the first 24 hours, 56% were surgically stabilized, 32 of them with intramedullary nails with an average duration of 122 minutes. The incidence of isolated fractures of the femur or tibia was 2.04%, of which polytraumatized was 10%. The two patients entered the first post-traumatic hour with closed diaphyseal fractures of the femur, one with an open contralateral tibial fracture and stabilized two hours after admission with external fixators at 80 minutes on average. No patient died.
Discussion: 1. The study does not show conclusive influence of any of the variables handled, this allows us to think that SEG depends more on the host's own response to fatty acids than on their origin. 2. The incidence of SEG in this work was lower than that reported in a previous study in this same institution with the same population of patients, where no endovenous fluid and oxygen protocol was used.