scholarly journals Histopathological evaluation of autopsy cases with isolated pulmonary fat embolism (IPFE): is cardiopulmonary resuscitation a main cause of death in IPFE?

2019 ◽  
Vol Volume 11 ◽  
pp. 121-127
Author(s):  
Emine Turkmen Samdanci ◽  
Muhammet Reha Celik ◽  
Sultan Pehlivan ◽  
Osman Celbis ◽  
Dilhan Turkkan ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Cause Of Death ◽  
Fat Embolism ◽  
Pulmonary Fat Embolism ◽  
Histopathological Evaluation

scholarly journals Iatrogenic pulmonary fat embolism after surgery in a patient with fatty liver

2020 ◽  
Vol 77 (3) ◽  
pp. 340-343
Author(s):  
Dragan Mitrovic ◽  
Svetlana Lazarevic
Keyword(s):  
Fatty Liver ◽  
Cause Of Death ◽  
Bone Fractures ◽  
Subcutaneous Fat ◽  
Hypovolemic Shock ◽  
Fat Embolism ◽  
Pulmonary Vasculature ◽  
Hepatic Veins ◽  
Pulmonary Fat Embolism ◽  
Liver Change

Introduction. Fat embolism refers to the presence of fat globules in the lung parenchyma and its peripheral circulation. Obstruction of the lung vessels by fat emboli can lead to acute cor pulmonale when the compensatory capabilities of the pulmonary vasculature are exceeded. Case report. We presented a case of a 78-year old man who suffered a dissection of abdominal aortic aneurysm. Urgent surgical procedure was performed and aneurysm replaced with aortobifemoral bypass grafting using a Dacron graft. Despite the procedure the patient died the following day. The autopsy revealed that the cause of death was hypovolemic shock. There were no bone fractures (also no fractures of ribs and sternum from cardiopulmonary resuscitation) or injuries of the subcutaneous fat tissue or other organs (besides those from the surgery). However, additional autopsy findings included fatty liver change, small liver hemorrhages (confirmed microscopically), as well as a presence of fat droplets in the hepatic veins, as well as in the pulmonary vessels, i.e. pulmonary fat embolism [confirmed with hematoxylin/ eosin (H/E), and Sudan III staining], which could be the contributing cause of death. Conclusion. The presented case indicates that pulmonary (or even systemic) fat embolism should be considered as the possible iatrogenic cause of unexpected and unexplained death in the cases where elective surgical procedures were performed in patients with fatty liver change. Pathologists must be aware of this possibility, since it is not easily recognized on routine H/E staining, and some of the special staining technique should be applied.

Fatal pulmonary fat embolism after posterior spinal fusion surgery

2006 ◽  
Vol 11 (2) ◽  
pp. 217-220 ◽  
Author(s):  
Yoshimasa Takahashi ◽  
Ken’ichiro Narusawa ◽  
Kenji Shimizu ◽  
Masakazu Takata ◽  
Toshitaka Nakamura
Keyword(s):  
Spinal Fusion ◽  
Posterior Spinal Fusion ◽  
Fat Embolism ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery ◽  
Pulmonary Fat Embolism

Pulmonary fat embolism in cases of fatal hypothermia

2007 ◽  
Vol 169 ◽  
pp. S5 ◽  
Author(s):  
J. Preuß ◽  
R. Dettmeyer ◽  
C. Ortmann ◽  
E. Lignitz ◽  
B. Madea
Keyword(s):  
Fat Embolism ◽  
Pulmonary Fat Embolism ◽  
Fatal Hypothermia

VALUE OF ARTERIAL HYPOXEMIA IN THE DIAGNOSIS OF PULMONARY FAT EMBOLISM

1972 ◽  
Vol 16 (6) ◽  
pp. 521
Author(s):  
P. R. BENOIT ◽  
L. G. HAMPSON ◽  
J. H. BURGESS
Keyword(s):  
Fat Embolism ◽  
Arterial Hypoxemia ◽  
Pulmonary Fat Embolism

Cardiac Damage in a Model of Pulmonary Fat Embolism

CHEST Journal ◽  
2014 ◽  
Vol 146 (4) ◽  
pp. 207A
Author(s):  
Darwish Naji ◽  
Shehabaldin Alqalyoobi ◽  
Betty Herndon ◽  
Agostino Molteni ◽  
Gary Salzman
Keyword(s):  
Fat Embolism ◽  
Cardiac Damage ◽  
Pulmonary Fat Embolism

scholarly journals Pulmonary Fat Embolism and Coronary Amyloidosis

2018 ◽  
Vol 19 ◽  
pp. 744-747 ◽  
Author(s):  
Veronica Lever ◽  
Francesco Erdini ◽  
Claudio Ghimenton ◽  
Luca Novelli ◽  
Matteo Brunelli ◽  
...  
Keyword(s):  
Fat Embolism ◽  
Pulmonary Fat Embolism

scholarly journals Factors that could influence the severity of post-traumatic lung fat embolism - a prospective histological study -

2003 ◽  
Vol 131 (5-6) ◽  
pp. 244-248 ◽  
Author(s):  
Slobodan Nikolic ◽  
Jelena Micic ◽  
Slobodan Savic ◽  
Milan Gajic
Keyword(s):  
Cause Of Death ◽  
Histological Study ◽  
Subcutaneous Fat ◽  
Hypovolemic Shock ◽  
Fat Embolism ◽  
Older Individuals ◽  
Fat Globules ◽  
Sudan Iii ◽  
Post Traumatic ◽  
Severe Grade

INTRODUCTION Each fracture of long or pelvic bones as well as large contusions of subcutaneous fat tissue cause releasing of fat globules that rapidly penetrate into circulation through the ruptured veins of the injured tissue, and reach the lung circulation [1,2]. During the first phase, fat emboli block the functional lung circulation by their mechanical effect in capillaries producing so called isolated post-traumatic lung fat embolism [3]. The surface layer of a fat embolus, which is practically in liquid state, behaves as a membrane of very high density, i.e., as it is under high pressure which obstruct the blood stream [4] that is finally stopped at the level of lung blood vessels with diameter of approximately 20 ? [5].This pathophysiological mechanism produces cor pulmonale acutum, with poor pathological findings [8]. Nowadays, the post-mortem diagnosis of lung fat embolism is based on microscopical examination of tissue specimens, usually prepared with special histological staining (Sudan III) [9]. The grading of fat embolism according to Sevitt's criteria is generally accepted [10]. Taking of slices from apicoventral areas of the lungs has been recommended [11]. With longer outliving period, the total number of fat emboli in the lung circulation gradually decreases, due to their disintegration and resorption. It has been stated that fat globules completely disappear about 4-6 weeks after injury, and that they should not be searched for microscopically in this post-traumatic phase [11]. OBJECTIVES The aim of our work was to determine whether the age of injured, their gender, total severity of trauma, outliving period, and hypovole-mic shock that develops after injuring, may induce development of more severe forms of post-traumatic lung fat embolism. MATERIAL AND METHODS A prospective histological study was performed on the autopsy material of the Institute of Forensic Medicine in Belgrade. The analyzed sample consisted of individuals with injuries that might be a source of fat emboli (fractures of long bones, large contusions of subcutaneous fat tissue). The lung slices were systematically taken and stained with special fat staining (Sudan III). In each particular case, the grade of lung fat embolism was counted on the basis of microscopical appearance, according to Sevitt's criteria. The total severity of trauma was estimated by calculation of the Injury Severity Score (ISS) [13,14]. In no cases from the analyzed sample, the fat embolism was mentioned as either singular or plural cause of death. The obtained results were analyzed by means of appropriates statistical methods (ANOVA LSD-test, x2 test, Man-Whitney test, Fischer's test of correct probability). RESULTS AND DISCUSSION The analyzed sample included 58 fatally injured individuals, 39 males and 19 females. The average age was 54.10 years (SD=16.56), the average value of ISS was 34.69 (SD=5.88), and the average outliving period was 3.74 days (SD=5.88). However, all these data look differently when the analyzed sample has been stratified and analyzed according to the estimated grade of lung fat embolism. It was not showed that severity of lung fat embolism depends on sex of the injured (^2=0.842 p>0.05). The groups with the slightest and the most severe grade of lung fat embolism are statistically significantly different in relation to age of individuals (ANOVA, p=0.017). By means of LSD test, it has been showed that the group with the most severe grade of lung fat embolism (grade III) is statistically significantly different comparing to other two groups (with grade I and II) in relation to the age of injured (the values are p=0.16 and p=0.19 respectively, and the both groups are less than p=0.05). In the group with the most severe grade of lung fat embolism, the older individuals are statistically significantly represented comparing to othertwo groups. CONCLUSION The analysis of our sample showed that the most severe grade of post-traumatic lung fat embolism (microscopical grade III according to Sevitt's criteria) was determined in older individuals, more severely injured, and with shorter outliving period. The severity of fat embolism depends neither on sex of the injured, nor on development of post-traumatic hypovolemic shock. The obtained results related to the influence of hypovolemic shock on severity of fat embolism should be accepted with a caution. Namely, sometimes there is an intention to simplify a procedure of creating of autopsy conclusion about the cause of death, so that loss of blood is not mentioned at all, in spite of fact that it could have been a concurrent cause of death, while in other cases exsanguination is designated as a sole cause of death, forgetting the possibility that fat embolism could have really been the immediate cause of death.

Fatal pulmonary fat embolism during humeral fracture repair in a cat

2001 ◽  
Vol 42 (4) ◽  
pp. 195-198 ◽  
Author(s):  
T. Schearz ◽  
P. E. Crewford ◽  
M. R. Owen ◽  
C. K. Störk ◽  
H. Thompson
Keyword(s):  
Humeral Fracture ◽  
Fat Embolism ◽  
Fracture Repair ◽  
Pulmonary Fat Embolism

ANCHORING BIAS AFFECTING THE OUTCOME OF PULMONARY FAT EMBOLISM

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A2154
Author(s):  
Muhammad Bilal ◽  
Anam Umar ◽  
Beena Ahsan ◽  
Anita Gopalakrishnan ◽  
Victor Blake
Keyword(s):  
Fat Embolism ◽  
Pulmonary Fat Embolism ◽  
Anchoring Bias

scholarly journals Does Unreamed Nailing Prevent Pulmonary Fat Embolism?

1999 ◽  
Vol 14 (S1) ◽  
pp. S78-S79
Author(s):  
Keiji Tanaka ◽  
Masateru Shindo ◽  
Kazui Soma ◽  
Mituhiro Hirata ◽  
Takashi Ohwada
Keyword(s):  
Fat Embolism ◽  
Pulmonary Fat Embolism ◽  
Unreamed Nailing
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