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©The Author(s) 2021.
World J Clin Cases. Sep 26, 2021; 9(27): 8260-8267
Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8260
Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8260
Table 1 Laboratory examinations
Variable | Reference range | 1.5 h after trauma | 3 h after trauma | 5 h after trauma |
RBC, 1012/L | 3.8-5.1 | 3.86 | 3.73 | 2.54 |
WBC, 109/L | 3.5-9.5 | 18.35 | 23.79 | 9.55 |
HG level, g/L | 115-150 | 84.00 | 92.00 | 61.20 |
HCT level, % | 35-45 | 28.70 | 29.70 | 19.82 |
PLC, 109/L | 125-350 | 340.00 | 243.00 | 92.40 |
ALT level, U/L | 7-40 | 19.10 | 21.30 | 18.70 |
AST level, U/L | 13-35 | 26.20 | 29.30 | 45.00 |
Total protein level, g/L | 65-85 | 66.30 | 49.20 | 41.30 |
Albumin level, g/L | 40-55 | 41.60 | 29.10 | 26.50 |
Arterial blood gas level | ||||
Partial pressure of CO2, mmHg | 35-45 | 30.50 | 24.90 | |
Partial pressure of O2, mmHg | 80-100 | 80.50 | 160.30 |
Table 2 Demographic profile of the reported fat embolism syndrome patients whose latent period was < 12 h
Ref. | Age/gender | Latent period | Trauma | Outcome |
Tsuru and Adachi[13] | 83/F | 55 min | Left distal femur fracture | Comatose and eventually died |
Chen et al[17] | 31/M | 1 h | Right femoral and tibia fracture | Comatose and eventually died |
Scarpino et al[18] | 17/M | 2 h | Right open femur and tibia fracture | Brain death on hospital day 2 |
Our case | 29/F | 2.5 h | The middle and left femur fracture | After 29 d in a coma, she became conscious. Returned to work at 6 mo after trauma |
You et al[19] | 54/M | 2 h 53 min | Multiple fracture (rib, clavicle, femur) and pulmonary contusion and pneumothorax | Brain death on hospital day 5 |
Dillerud[20] | 25/M | 3 h | Right femur and left tibiofibular fracture | Minimal memory impairment |
Millen et al[21] | 17/F | 4 h | Multiple fracture (rib, clavicle, femur, tibia, fibular, pubic rami, sacral ala) | After 2 mo in a coma, she was alert, oriented, following with progressively improving cognition |
Xu et al[22] | 63/W | 4 h | Right tibia and fibula fractures | One month later, the patient was discharged from the hospital without any residual neurological deficit |
Yang et al[23] | 46/W | 5 h | Left femur fracture | Patient consciousness was restored but language disorders were left |
Cronin et al[24] | 26/M | 6 h | Right open tibiofibular shaft fracture | Returned to work at 3 mo after trauma |
Paredes et al[4] | 54/M | 10 h | Multiple fractures: Femoral shaft, radius, patella, metatarsal | A residual mild cognitive impairment |
Table 3 Gurd’s criteria
Gurd’s criteria |
Major criteria |
Petechial rash |
Respiratory symptoms with radiographic changes |
Central nervous system signs unrelated to trauma or other condition |
Minor criteria |
Tachycardia |
Pyrexia |
Retinal changes (fat or petechiae) |
Renal abnormalities (oliguria, anuria, or lipiduria) |
Acute thrombocytopenia |
Acute decrease in hemoglobin |
High erythrocyte sedimentation rate |
Fat globules in sputum |
- Citation: Yang J, Cui ZN, Dong JN, Lin WB, Jin JT, Tang XJ, Guo XB, Cui SB, Sun M, Ji CC. Early acute fat embolism syndrome caused by femoral fracture: A case report. World J Clin Cases 2021; 9(27): 8260-8267
- URL: https://www.wjgnet.com/2307-8960/full/v9/i27/8260.htm
- DOI: https://dx.doi.org/10.12998/wjcc.v9.i27.8260