1995 Fat intravasation, fat emboli and fat embolism syndrome in adult major trauma patients with intraosseous catheters; a systematic review

Conclusion In total, twenty-seven abstracts were identified and n=7 met full inclusion criteria (table 1). All papers were large animal translational studies. The overall risk of bias was high. Fat intravasation and fat embolisation were observed to be near-universal following IO infusion, but of uncertain clinical significance. In one study, high infusion pressures were associated with immediate cardiovascular instability which was attributed to FES. The initial IO flush appeared to be the procedure with the highest intramedullary pressure. No conclusions could be made on FES from the study methodologies. Intraosseous catheters remain a useful intervention in the armamentarium of trauma clinicians. Although their use is widely accepted, there is a paucity of evidence exploring the risks of fat embolisation in IO infusions. The existing data is of low quality with a high risk of bias. Despite this, pulmonary fat emboli after IO infusion are common. More research is needed to quantify the clinical significance of fat embolism and FES after IO infusion in adult major trauma patients. Abstract 1995 Table 1Systematic review of pulmonary fat emboli associated with intraosseous (IO) use in seven controlled swine studies Authors Study Population Bone Flush Infusion method IO system used Relevant outcome measure Relevant results Plewa et al. 1995. doi:10.1111/j.1553 n= 16, weight 5.9-12.3kg Proximal tibia 1 ml NaCl 0.9% 3-way tap, manual pressure Jamshidi Post-mortem ana...
Source: Emergency Medicine Journal - Category: Emergency Medicine Authors: Tags: RCEM Lightning Papers Source Type: research