Distention of thrombi-occluded capillaries → ↑ intracapillary pressure → extravasation of RBCs into the skin → petechial rash.Dermatologic and neurological manifestations (see “Clinical features”): The exact mechanism is unknown but may be due to paradoxical embolisms or biochemical factors (e.g., systemic cytokine release).Lipases metabolize the lodged fat cells (in pulmonary arterioles) → release of free fatty acids → pulmonary arteriolar endothelial injury → acute lung injury/ respiratory distress.Nontraumatic fat embolism: ↑ cytokine levels (e.g., CRP, TNF) → agglutination of chylomicrons in the circulation → fat emboli formation.Traumatic fat embolism: fat cells from bone marrow enter systemic circulation and occlude the pulmonary arterioles → right heart failure and pulmonary edema.Others: pancreatitis, osteomyelitis, parenteral lipid infusionĮarly operative fixation is recommended in patients with long bone fractures to reduce the risk of fat embolism syndrome.Most commonly long bone fractures (e.g., femoral fracture ).Fat embolismĪ potentially life-threatening condition caused by the entry of fat cells, usually from bone marrow, into the circulatory system Etiology Management of cardiac arrest in pregnancyīoth arterial air embolism and venous air embolism can be caused by laparoscopic surgery, cardiac and vascular surgery, endoscopic procedures, ECMO, and diving-related injuries.įat embolism, air embolism, and AFE are all clinical diagnoses.Arterial line: Stop flush and open the rotating hemostatic valve.Place the patient in the supine position.Consider right heart air aspiration through CVC.PIV line: Drop infusion source below heart level.Apply an occlusive dressing to open wounds or catheter sites.Place the patient in the left lateral decubitus position and Trendelenburg position.RV dysfunction followed by severe LV dysfunction on echocardiography.Fetal debris, cells, and/or hair in pulmonary artery sample.Air bubbles in retinal vessels on fundoscopy.Signs of systemic organ ischemia on imaging (e.g., stroke neuroimaging).Air in left heart chambers on echocardiography.Air in right heart chambers and pulmonary circulation on imaging and echocardiography. ![]()
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