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Fat-Embolism Syndrome (Respiratory Insufficiency Syndrome) A RATIONALE FOR TREATMENT
DAVID G. MURRAY; GABOR B. RACZ
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From the Departments of Orthopedic Surgery and Anesthesia, Upstate Medical Center, State University of New York, Syracuse
1974 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1974; 56:1338-1349 
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Abstract

Based on experience gained in the management of thirteen consecutive cases of fat-embolism syndrome with 100 per cent survival, a treatment program was developed on the assumption that the potentially fatal feature is hypoxia secondary to pulmonary insufficiency. Blood-gas studies were done immediately on all patients who exhibited any combination of tachycardia, tachypnea, pyrexia, and impairment of consciousness after trauma. An arterial oxygen level below fifty millimeters of mercury was an indication for vigorous treatment. Therapy in severe cases included controlled, positive pressure ventilation with positive end-expiratory pressure and diuretics as indicated. The goal of treatment was to maintain arterial oxygen above fifty millimeters of mercury until the pathological process in the lungs resolved and normal function was restored. All patients survived.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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