Fat emboli-Related diffuse alveolar haemorrhage (FEDAH) an acronym to remember-Case series.
Benjamin Earnest WilliamsAvinash Anil NairPrince JamesBarney IsaacRicha GuptaAnand AshokPublished in: Respirology case reports (2023)
Fat embolism syndrome (FES) is a rare but potentially fatal complication of trauma or orthopaedic surgery, which presents predominantly with pulmonary symptoms. The rapid worsening respiratory failure in a previously normal orthopaedic surgery or trauma patients usually get evaluated for pulmonary embolism, fat-embolism-related acute respiratory distress or transfusion related acute lung injury. Orthopaedic surgeons and clinicians need to be aware of related entity termed ' F at E mbolism related D iffuse A lveolar H aemorrhage' (FEDAH). The clinical presentation in an orthopaedic surgery of trauma patient with FEDAH are haemoptysis, worsening type 1 respiratory failure and oxygen requirement, drop in haemoglobin levels with chest x-ray/computed tomography suggestive of Diffuse alveolar haemorrhage (DAH). Early bronchoscopy and bronchoalveolar lavage (BAL) confirmation of DAH, presence of BAL haemosiderophages and lipid-laden macrophages are the pointers in the early diagnosis of FEDAH. It needs a high clinical suspicion and interdepartmental collaborative measures. Timely referral from orthopaedic surgeons, early bronchoscopy and treatment with steroids is key in diagnosis and management.
Keyphrases
- respiratory failure
- pulmonary embolism
- minimally invasive
- trauma patients
- computed tomography
- adipose tissue
- extracorporeal membrane oxygenation
- coronary artery bypass
- mechanical ventilation
- fatty acid
- palliative care
- magnetic resonance
- high resolution
- primary care
- quality improvement
- atrial fibrillation
- depressive symptoms
- inflammatory response
- positron emission tomography
- drug induced
- pulmonary hypertension
- mass spectrometry
- case report
- physical activity
- acute kidney injury
- cardiac surgery
- lps induced