چكيده لاتين :
Fat embol ism syndrome refers to a constellation of symptoms
secondary to the presence of fat globules in the lung parenchyma
and/or peripheral blood circulation. The syndrome is
most often seen in association with long bone or pelvic fractures
and can cause significant morbidity and mortality. The
present randomized double blind placebo-controlled trial was
conducted to evaluate the efficacy of prophylactic corticosteroids
in the prevention of fat embolism syndrome and arterial
hypoxia in patients with long bone fractures. Ninety-one patients
with long bone fractures were randomized to case and
control groups; 38 and 53 individuals, respectively . The patients
in the case group received a single dose of 10 mg/kg
intravenous methylprednisolone succinate upon presentation
to the emergency room. The control group received placebo
(normal saline). The primary endpoints evaluated were tire
יpresence of fat embolism syndrome, based on the Gurd criteria.
Total two patients with fat embolism syndrome were observed
in the corticosteroid-treated group (5/2%) compared
with five patients in the control (9.4%; P=0.4). Arterial hypoxemia
was observed in one patient in the corticosteroidtreated
group (2/6%) versus eight patients in the control group
(17/0%; P= 0.07). Mean arterial oxygen was not significantly
different between the two groups (P=0.07). It seems that
single dose methylprednisolone succinate (10 mg/kg intravenously)
is not effective as prophylaxis for fat embolism syndrome
and arterial hypoxemia.
