Human Albumin and N-Acetylcysteine for Treatment of Fat Embolism: A Case Report

Niraj Kumar Keyal,Sanjeev Kumar Yadav,Manish Nakarmi,Amid Bhujel

doi:10.31729/jnma.4478

Niraj Kumar Keyal, Sanjeev Kumar Yadav + Show 2 more

Open Access

https://doi.org/10.31729/jnma.4478

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Abstract

Fat embolism is a life-threatening condition that mostly occurs after long bones and pelvis fractures and treatment is controversial with many available drugs. We hereby present a case of 53 years male who developed shortness of breath, tachycardia, fever, anemia, distended jugular vein, thrombocytopenia, hypoalbuminemia and was diagnosed to have fat embolism after fracture of femur, tibia, fibula and pubic rami following road traffic accident. Patient was treated with 20 percent human albumin, N-acetylcysteine, other supportive treatment and discharged after fourteen days. From this we want to emphasize role of human albumin and N-acetylcysteine in treatment of fat. Keywords: fat embolism; human albumin; N-Acetylcysteine.

Highlights

Fat embolism is presence of fat globules in microcirculation and lung parenchyma
There is a lack of specific clinical symptoms and laboratory parameters for diagnosis of fat embolism different criteria are used to diagnose fat embolism but none of them are specific
Treatment is usually supportive due to unavailability of specific treatment and treatment is controversial with methylprednisone, heparin, aspirin, n-acetylcysteine, albumin and inferior vena caval filter.[4]

Summary

Introduction

Fat embolism is presence of fat globules in microcirculation and lung parenchyma. It commonly occurs following trauma to long bones and pelvis in 95% and it is non traumatic in 5%.1 The incidence ranges from 0.25% to 33%. It usually occurs within 12 to 72 hours but it can occur as early as 6 hours to 10 days.[2] Fat embolism has mortality of 10-15% due to its lack of specific symptom and treatment.[3] Gurd’s, Lindeque’s, Schonfeld criteria are used to diagnose fat embolism. This case report shows successful treatment with controversial drugs like Albumin and N-acetylcysteine. Patient was resuscitated with blood products and other supportive management.

Results

Conclusion