The cognitive effects of fat embolus syndrome following an isolated femoral shaft fracture. A case report.
The cognitive effects of fat embolus syndrome following an isolated femoral shaft fracture. A case report.
复制标题
孤立性股骨干骨折后脂肪栓塞综合征的认知影响。
DOI：
10.2106/jbjs.f.00196
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
C. Robinson
中科院分区：
文献类型：
--
作者：
Andrew C. Gray;L. Torrens;Timothy O. White;A. Carson;C. Robinson
创伤后脂肪栓塞综合征和急性呼吸窘迫综合征的神经学特征包括急性意识模糊、头痛、嗜睡、易激惹、癫痫发作、中风和昏迷。这些被认为是由脑栓塞和继发性低氧血症引起的1，2。从脂肪栓塞综合征中恢复的患者的长期认知影响尚不清楚。我们提出的情况下，病人谁恢复后，发展脂肪栓塞综合征后，孤立的股骨干骨折。全面的神经心理学测试显示，明显的和持续的认知功能障碍后18个月的初始侮辱。我们的患者被告知将提交有关该病例的数据以供发表。
一名23岁的女性分析化学家，受过学位教育（理学学士），以前没有医疗投诉，在一次足球铲球后右股骨干发生孤立性横向骨折，没有相关的胸部损伤。入院时，室内空气氧饱和度正常，为98%。在急诊室进行纵向皮肤牵引以稳定骨折，为髓内固定做准备。入院后6小时，出现急性呼吸困难和心动过速，患者出现一过性无反应。最大氧疗时氧饱和度降至84%。她被转移到重症监护室，在那里测得动脉氧分压（PaO 2）为8.3 kPa，吸入氧分数（FiO 2）为0.6，导致PaO 2/FiO 2比值为13.8。符合急性呼吸窘迫综合征和脂肪栓塞综合征的诊断标准3。患者接受插管，需要气道正压通气以维持适当的动脉血氧饱和度水平。在这种通气支持下，患者的呼吸状态似乎得到了良好的控制，动脉血氧浓度>10 kPa。入院后18小时，...
Documented neurological features of fat embolus syndrome and acute respiratory distress syndrome following trauma include acute confusion, headache, lethargy, irritability, seizure, stroke, and coma. These are thought to result from cerebral embolization and secondary hypoxemia1,2. The long-term cognitive effects in patients who recover from fat embolus syndrome are unclear. We present the case of a patient who recovered after the development of fat embolus syndrome following an isolated femoral diaphyseal fracture. Comprehensive neuropsychological testing revealed appreciable and persistent cognitive dysfunction eighteen months after the initial insult. Our patient was informed that data concerning the case would be submitted for publication.
Atwenty-three-year-old female analytical chemist, educated to a degree level (Bachelor of Science), with no previous medical complaints, sustained an isolated transverse fracture of the right femoral diaphysis with no associated chest injury after a soccer tackle. At the time of admission, the oxygen saturation level on room air was normal at 98%. Longitudinal skin traction was applied in the emergency department to stabilize the fracture in preparation for intramedullary fixation. Six hours after admission, acute dyspnea and tachycardia developed, and the patient became transiently unresponsive. Oxygen saturation fell to 84% on maximum oxygen therapy. She was transferred to the intensive care unit, where the partial tension of arterial oxygen (PaO2) was measured at 8.3 kPa with an inspired oxygen fraction (FiO2) of 0.6, resulting in a PaO2/FiO2 ratio of 13.8. The diagnostic criteria for both acute respiratory distress syndrome and fat embolus syndrome were fulfilled3. The patient was intubated and required positive airway pressure ventilation to maintain an appropriate level of arterial oxygen saturation. The patient's respiratory status appeared to be well controlled with this ventilatory support, and the arterial oxygen concentration was >10 kPa. Eighteen hours after admission, …