Q: 28 years old male is admitted to trauma ICU after a motor vehicle accident (MVA) with high probability of fat embolism. A pulmonary artery catheter (PAC) is floated. Wedged sample from the distal port of PAC failed to show any fat globules. This excludes the diagnosis of fat embolism?
A) True
B) False
Answer: B
Although fat embolism is defined as the presence of fat globules in pulmonary circulation, absence of fat does not rule out the diagnosis. This question emphasizes that fat embolism syndrome (FES) is still a clinical diagnosis, depending on history and clinical signs. Although classic practice advocates swan-ganz catheter (PAC) floating, it is neither sensitive nor specific for FES. Floatation of a swan exclusively to rule out FES is not very prudent.
#pulmonary
Reference:
Gerald L Weinhouse: Fat embolism syndrome (FES): https://www.uptodate.com/contents/fat-embolism-syndrome © 2023 UpToDate, Inc. (last accessed June 24, 2023)
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