Related Experiment Video
Updated: Jul 31, 2026
06:22
Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)
Published on: April 7, 2021
Sequential changes in gas exchange following traumatic fat embolism
R M Burnstein1, J P Newell, J G Jones
1University Department of Anaesthesia, Addenbrooke's Hospital, Cambridge, UK.
Anaesthesia
|June 5, 1998
Summary
Fat embolism syndrome following a femur fracture can cause respiratory issues like shunt and ventilation/perfusion mismatch. These complications can worsen with anesthesia, highlighting the need for careful monitoring.
Area of Science:
- Medical Physiology
- Respiratory Medicine
- Trauma Surgery
Background:
- Fat embolism syndrome (FES) is a potential complication following long bone fractures, particularly of the femur.
- FES can lead to significant respiratory compromise, including impaired gas exchange.
- Quantifying these physiological changes is crucial for understanding disease progression and management.
Observation:
- A young male patient with a fractured femoral shaft developed symptoms consistent with fat embolism syndrome.
- Continuous monitoring of oxygen saturation and inspired oxygen levels was performed.
- Ventilation/perfusion (V/Q) mismatch and shunt fraction were assessed over time.
Findings:
- The patient exhibited significant shunt and V/Q mismatch, indicative of impaired lung function.
- These respiratory abnormalities showed gradual improvement in the week post-admission.
- A notable deterioration in gas exchange occurred after undergoing general anesthesia for femoral nailing.
Implications:
- This case demonstrates the dynamic nature of respiratory compromise in FES.
- Anesthesia and surgical intervention can acutely worsen gas exchange in FES patients.
- Close respiratory monitoring is essential throughout the management of FES, especially around surgical procedures.
Related Concept Videos
01:30Alterations in Respiration II
There are numerous types of normal and abnormal respiration. Based on ventilatory movements, breathing patterns are classified as regular, deep, or shallow. Examples include Biot's breathing, Cheyne-Stokes respiration, Kussmaul's breathing, hyperventilation, and hypoventilation. Each pattern is clinically significant and aids in evaluating patients.
In Biot's breathing, the respiratory rate and depth are irregular, alternating between periods of deep gasping and apnea. Common causes include...
In Biot's breathing, the respiratory rate and depth are irregular, alternating between periods of deep gasping and apnea. Common causes include...
01:21Acute Respiratory Failure-II
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:23Acute Respiratory Failure-IV
Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
01:29Pulmonary Embolism I: Introduction
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
01:08Pneumothorax II: Pathophysiology
Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance between...
01:10Atelectasis II: Pathophysiology
Atelectasis develops when alveoli lose their air and collapse inward. Because lung tissue is naturally elastic, these air sacs shrink rather than remaining open. Collapsed alveoli are no longer ventilated, reducing their role in gas exchange. Blood flow may continue in these regions, creating a ventilation–perfusion mismatch. Clinical findings include decreased breath sounds, dullness to percussion, reduced chest expansion, and decreased tactile fremitus as sound transmission through collapsed...