Fat Chuk blood clot syndrome (Fat embolism syndrome) is a syndrome. Caused by changes that occur after Homeostasis fracture After surgery, the orthophosphate Ping disc or conditions other than problems orthophosphate Ping disc. I happen to like Severe infection blunt injury, blood tranfusion as a condition caused a drop of fat, small blood and obstruction of blood vessels of organs important, such as lung brain heart kidney as tissue, organs ischemia. to culture. The work of organs that fail the group appeared out clinical symptoms are many Depending on the fat emboli to go to what obstructive incidence fat embolism.
In patients with limb bones were broken percent from 0.5 to 2.2 and in the case of multiple fracture the culture together with a pelvic fracture is found percentage 50-10%.
Fat embolism syndrome is a condition of critical illness in the growth and mortality rates as high as 5000 per year and the show symptoms at birth are different. Occur within 12 hours about 25 percent during the 36 hours, 75 percent and the 85 per cent within 48 hours causes the occurrence of fat embolism.
Causes are unknown. But the theory that most people believe is a bone marrow emboli that is when the tear of blood vessels in the bone marrow and fat tissue in the bone marrow into the blood drop. Fat droplets that come off (fat globules) combines with platlets, fibrin or red cell in blood vessels causing obstruction of blood vessels. Vascular wall cells and secrete substances destroyed. Thromboplastin, fatty acid and adenosine diphosphate which these materials will accelerate the coagulation of blood. Typically, the coagulation of blood could be the breakdown of the work of the fibrinolysis system, but in patients with depressed level of fat embolism substance that helps the body process of fibrinolysis is less blood clot break down.
Coagulation of the blood increased. The ability to break down blood clot. The patients had low hemoglobin and the erythrocyte sedimentation rate. thrombocytopenia. Detected the bleeding or blood spots under eyes and body lining signs and symptoms.
Signs and symptoms will be much less depending on the emboli to plug in various positions with much. Very little if any symptoms will disappear by themselves. For patients with severe changes of the system are different symptoms and signs that appear in various systems follows.
1. The obstructive respiratory system of capillary gas exchange will be reduced. The condition of low blood oxygen (Hypoxia), which is to stimulate the respiratory control center. Giving patients breathe faster, breathing hard and pant I may have a blood (blood sputum) gas pressure in the artery is reduced PO2 and PCO2 increased.
2. Cardiovascular system. Of the obstructive coronary artery. The pulmonary circulation changes. The increase in pulmonary vascular resistance. So it works right ventricles increased strength to resist. And the pressure increased. Pressure of the right ventricles increased. The right auricle to the squeezing force. Hypoxia and physical condition when trying to adapt. By increasing the amount of blood from the heart The heart is squeezing more. Cause symptoms fast pulse (tachycardia) may have some chest pain from symptoms of myocardial ischemia if blood pressure is very low and right ventricles fail
3. The nervous system caused by cerebral fat emboli not allow enough blood to the brain. Patients with symptoms restless confusion and absorption into insensibility. May have symptoms of muscle contraction spasms or part of a serious nature decerebrate rigidity may be destroyed only the brain tissue. Disability until the later treatment, such as urine does not hold one. Or Alzheimer's disease
4. Skin symptoms may not change And are often found in recently, if patients have severe symptoms. Patients may die before Symptoms include the skin. Of the blood spots (petichiae) found that the neck. Followed by chest shoulder arms lining eye (conjunctiva) of the lower eyelid.
5. Kidneys were not changed often. Conditions often associated with shock. There is little urine (oliguria) until it no urine (anuria) diagnosis Fat embolism syndrome.
1. The history and symptoms of the patient. Often in younger patients. Injured several of the fast breathing, fever, fast pulse restless confusion.
2. The laboratory to determine Aterial blood gas because state hypoxia is measure the most important condition fat embolism was the PO2 below 60 mmHg for P CO2 less than 55 mmHg or pH less than 7.3 ESR higher found. Hemoglobin decreased 3-5 gm% Platelet count lower than 150,000 / mm3 Hematocrit values lower than normal prothrombin time value is lower than normal blood was free fatty acid, chloesterol, triglyceride and fat found in urine, sputum
3. Radiography of the lung will find a ceiling look like white snow (snow storm) and From the electrocardiogram (EKG) was invert T wave and depressd ST segment due to Rt.Bundle branch block guidelines for treatment.
No drugs. Syndrome is directly However, treatment to relieve symptoms. The following treatment.
1. Of the oxygen. When was the first state Hypoxia and respiratory care. The adequacy of the blood. To adjust pH and electrolyte balance in the body. The nutrient that has enough power.
2. Chest physical therapy. To prevent infection, pneumonia lung deflation airbags.
3. To eliminate movement and mend the broken, especially in patients with multiple fracture in Finland. Surgical Steel was put firmly bone fixation (rigid internal fixation) to form long bones (long bone) in patients with multiple injury can reduce the incidence of fat embolism syndrome from 22% down to 4.5%.
For patients at risk of severe fat embolism to assess every patient on admission. Keeping track changes to various symptoms, including temperature, pulse rate, respiratory rate and blood pressure level of consciousness. Changes in neurological symptoms. Blood spots out of the body. If you see something wrong. The medical report and mend the broken. To the bone is still broken. To reduce the movement of the bone This is important to prevent fat embolism, or when the condition is then they will not cause more severe symptoms Principles of Nursing.
When severe fat embolism in the hospital, then follows.
1. Recorded vital signs every 15 minutes, and assessed symptoms. Symptoms of various systems.
2. Respiratory care to open The patient received oxygen treatment plan. The patient may receive O2 mask or respirator. The need to take care of the machine working efficiently.
3. View the follow-up blood gas PO2 and PCO2 and pH values to determine if the abnormal condition Hypoxia doctors to report immediately. To help And trace the other laboratories, such as CBC, electrolyte, Hematocrit, Hemoglobin.
4. Care to receive blood or fluid of the medical treatment plan. To prevent and correct conditions ¾ channel and blood Edit shock conditions adjust the pH balance in the body. In order to drain fat from the body. Prevent renal failure. And care to get enough nutrients. As well as drugs. Plan of medical treatment.
5. Rub the body to reduce fever.
6. Record amount of fluid the body has. Body fluid volume and drive out.
7. The patient has symptoms of restless confusion careful absorption into the accident. Must maintain close
8. Trace Others, such as chest X-ray, EKG.
9. To psychological care.
10. To prevent pressure ulcers and complications of pulmonary fat embolism syndrome, when conditions have been treated to provide relief. The patient has recovered. Perceived better Breathing itself is usually normal pulse of blood gas and chest X-ray and EKG is normal for doctors consider surgery to fixing broken bones.
