Thursday, January 25, 2018

non-long-bone-trauma causes of fat embolism

Q: Give ten examples of conditions causing 'fat embolism' other than long bone trauma? 

Answer: Though 'fat embolism' is mostly due to long bone traumas but many non-traumatic conditions (though uncommon) can be the cause of fat embolism. List is long but few ICU related causes may be (also see references):
  1. Chest compressions with or without rib fractures 
  2. Burns 
  3. Pancreatitis 
  4. Osteomyelitis 
  5. Prolonged steroid therapy 
  6. Sickle cell hemoglobinopathies 
  7. Lipid infusion 
  8. Cyclosporin A solvent 
  9. Intraoperative cell salvage 
  10. Cardiopulmonary bypass


References / further reading:

1. de Lima E Souza R, Apgaua BT, Milhomens JD, et al. Severe fat embolism in perioperative abdominal liposuction and fat grafting. Braz J Anesthesiol 2016; 66:324. 

2. Jacob S, Courtwright A, El-Chemaly S, et al. Donor-acquired fat embolism syndrome after lung transplantation. Eur J Cardiothorac Surg 2016; 49:1344. 

3. Schrufer-Poland T, Singh P, Jodicke C, et al. Nontraumatic Fat Embolism Found Following Maternal Death after Cesarean Delivery. AJP Rep 2015; 5:e1. 

4. Schonfeld SA, Ploysongsang Y, DiLisio R, et al. Fat embolism prophylaxis with corticosteroids. A prospective study in high-risk patients. Ann Intern Med 1983; 99:438. 

5. Garza JA. Massive fat and necrotic bone marrow embolization in a previously undiagnosed patient with sickle cell disease. Am J Forensic Med Pathol 1990; 11:83. 

6. Levine M, Skolnik AB, Ruha AM, et al. Complications following antidotal use of intravenous lipid emulsion therapy. J Med Toxicol 2014; 10:10. 


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