Severe fat embolism in perioperative abdominal liposuction and fat grafting

Revista brasileira de anestesiologia
Rodrigo de Lima E SouzaDeiler Célio Jeunon

Abstract

Fat embolism syndrome (FES) may occur in patients suffering from multiple trauma (long bone fractures) or plastic surgery (liposuction), compromising the circulatory, respiratory and/or central nervous systems. This report shows the evolution of severe FES after liposuction and fat grafting. SSS, 42 years old, ASA 1, no risk factors for thrombosis, candidate for abdominal liposuction and breast implant prosthesis. Subjected to balanced general anesthesia with basic monitoring and controlled ventilation. After 45minutes of procedure, there was a sudden and gradual decrease of capnometry, severe hypoxemia and hypotension. The patient was immediately monitored for MAP and central catheter, treated with vasopressors, inotropes, and crystalloid infusion, stabilizing her condition. Arterial blood sample showed pH = 7.21; PCO2 = 51mmHg; PO2 = 52mmHg; BE = -8; HCO3 = 18 mEq/L, and lactate = 6.0 mmol/L. Transthoracic echocardiogram showed PASP = 55mmHg, hypocontractile VD and LVEF = 60%. Diagnosis of pulmonary embolism. After 24h of intensive treatment, the patient developed anisocoria and coma (glasgow coma scale = 3). A brain CT was performed which showed severe cerebral hemispheric ischemia with signs of fat emboli in right middle ce...Continue Reading

References

Jun 30, 2009·Journal of Emergencies, Trauma, and Shock·Nissar Shaikh
Jan 1, 2008·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Nissar ShaikhMarie Anne Kattren
Jan 28, 2012·Postgraduate Medical Journal·Stefan BuchholzRavinay Bhindi

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Citations

Dec 20, 2017·Plastic and Reconstructive Surgery·Lázaro Cárdenas-CamarenaJorge Enrique Bayter-Marin
Jul 28, 2018·Plastic and Reconstructive Surgery·Héctor DuránJosé Antonio Robles-Cervantes
Jul 7, 2018·Plastic and Reconstructive Surgery·Rodrigo G Rosique, Marina J F Rosique
May 19, 2019·Aesthetic Surgery Journal·William PeñaAlvaro Andres Macias

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