Evidence map›Paper›PMID 39583486›Full record

ArticleCureus2024

A Case of Fatal Fat Embolism Syndrome During Osteosynthesis Saved by Veno-Arterial Extracorporeal Membrane Oxygenation.

Takashi Egashira, Toshiaki Nakamura, Akito Setoguchi, Masayoshi Takeno, Daiji Akiyama, Hiroshi Miyoshi, Jin Ikenaga, Masato Tomita

Abstract readCase Reports
In one paragraph

Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Takashi EgashiraDepartment of Intensive Care, Nagasaki Harbor Medical Center, Nagasaki, JPN.
Toshiaki NakamuraDepartment of Intensive Care, Nagasaki Harbor Medical Center, Nagasaki, JPN.
Akito SetoguchiDepartment of Cardiovascular Medicine, Nagasaki Harbor Medical Center, Nagasaki, JPN.
Masayoshi TakenoDepartment of Cardiovascular Medicine, Nagasaki Harbor Medical Center, Nagasaki, JPN.
Daiji AkiyamaDepartment of Anesthesiology, Nagasaki Harbor Medical Center, Nagasaki, JPN.
Hiroshi MiyoshiDepartment of Anesthesiology, Nagasaki Harbor Medical Center, Nagasaki, JPN.
Jin IkenagaDepartment of Orthopedic Surgery, Nagasaki Harbor Medical Center, Nagasaki, JPN.
Masato TomitaDepartment of Orthopedic Surgery, Nagasaki Harbor Medical Center, Nagasaki, JPN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Fat embolism syndrome (FES) occurs when fat droplets from bone marrow or adipose tissue enter the circulation due to bone fractures or surgical interventions. It typically develops 12 to 72 hours after injury. However, fulminant FES, characterized by its rapid onset, is rare and can rapidly progress to a life-threatening condition. In this case report, a 90-year-old woman underwent osteosynthesis on the fourth day after admission (day 4) following a femoral diaphyseal fracture. During the insertion of an intramedullary nail into the femur, rapid deterioration of oxygenation was observed, followed by shock and severe right heart failure. Emergency veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was initiated. Suspecting thromboembolism, contrast-enhanced CT was performed, but no massive thrombus was found in the pulmonary artery. Based on the clinical course, we diagnosed fulminant FES. The patient received respiratory and circulatory support with VA-ECMO, along with reduction of the right heart afterload using inhaled nitric oxide (iNO) and phosphodiesterase III inhibitors. The patient was successfully weaned off ECMO on day 7, iNO was discontinued on day 10, and the ventilator was removed on day 11. The patient was subsequently transferred to the general ward on day 13, where she exhibited no significant neurological deficits. Although fat embolism syndrome can only be managed symptomatically, the patient's outcome was favorable because of the prompt initiation of ECMO in response to the fulminant presentation.

Indexed as

ardsecmofulminant fat embolism syndromeosteosynthesisshock

Identifiers

PMID39583486
PMCPMC11585365

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.