Predictive signs of fat embolism syndrome. Case-control study

Abstract

Objectives. To study the significance of biochemical parameters and fat globulemia in predicting the development of fat embolism in severe combined trauma.

Materials and methods. The study included 637 patients with severe combined trauma (615 patients — without developing fat embolism and 22 patients — with fat embolism). We determined the relationship of increased glucose, lactate, non-esterified fatty acids, and fat globulemia at the time of admission to the hospital with the development of fat embolism.

Results. The presence of hyperglycemia and hyperlactatemia does not affect the prediction of fat embolism. In 20 out of 22 patients with fat embolism, the values of non-esterified fatty acids during hospitalization exceeded 1.3 mmol/l. Trauma with an Injury Severity Score of ≥ 17 points is accompanied by fat globulemia in 100 % of cases. The relationship between the number of globules larger than 50 microns at the time of admission to the hospital and the development of fat embolism was determined.

Conclusion. In patients with trauma at the time of admission to the hospital, an increase in the content of non-esterified fatty acids in venous blood and the presence of fat globules larger than 50 microns in the blood plasma can serve as a prognostic criterion for the development of fat embolism in the early post-traumatic period.