اثربخشي كورتيكواستروييدها در جلوگيري از سندرم آمبولي چربي در بيماران با شكستگي اسستخوانهاي بلند

Efficacy of corticosteroids in prevention of fat embolism syndrome in patients with long bone fracture

Introduction: Fat embolism syndrome refers to the presence of fat globules in lung parenchyma and/or peripheral blood circulation. The syndrome most often is seen in association with long bone or pelvis fractures and can lead to patients death. Considering prophylaxis the strongest argument has been about the efficacy of corticosteroids. Methods: This study was conducted to determine the efficacy of corticosteroids in prevention of fat embolism syndrome and arterial hypoxia in 91 patients with long bone fractures. Patients meeting the inclusion criteria were divided randomly to control and case groups and the case group received the drug. Results: In total, 2 cases of fat embolism syndrome were observed in the corticosteroid-treated group (5/2%) and 6 in the control (10/1%) (P=0.4). Arterial hypoxemia was observed in one of the corticosteroid-treated group (2/6%) and in 8 of the control (15.0%) (none of them severe) (p=0.07). The mean arterial oxygen pressure did not show any statistically significant difference (p =0.07). Conclusion: According to this data, methylprednisolone succinate, in the used dosage, is not effective in prevention of fat embolism syndrome and arterial hypoxemia.