Is serum lactic acid a reliable indicator for diagnosing fat embolism syndrome?

Chandra Sekhar Bhumireddy, Surendra Umesh Kamath, Sunil Lakshmipura Krishnamurthy

Research output: Contribution to journalArticle

Abstract

Introduction: The incidence of Fat Embolism Syndrome (FES) has been reported to occur in 0.5 to 3% of patients with isolated long bone fracture. FES is most commonly associated with long bone fractures, if associated with polytrauma then the chance of manifestation increases by 11%. Fat embolism is a clinical entity diagnosed mainly by Gurd’s criteria which includes clinical signs and blood parameters. There is no single blood parameter to detect FES at earliest. A high lactate level is an early sign of tissue hypoxia. In patients with femur shaft fracture tissue hypoxia is the most important cause of increased lactate levels. Increased blood lactate level is related to increased mortality. Aim: To establish the relationship between serum lactic acid and fat embolism in patients with fracture shaft of the femur. Materials and Methods: The present was a prospective study done at Kasturba Medical College Hospitals, Mangalore, Karnataka, India, on 40 patients with femur shaft fracture. Statistical analysis was done using SPSS (version 17.0). Results: In the present study, four patients out of 40 had FES (Gurd’s criteria), whose serum lactic acid was high (>25) within 72 hours of injury. Fourteen patients had elevated lactic acid (>20) but did not develop FES. All patients with FES had elevated serum lactic acid which was statistically significant (p-value 0.003), yet serum lactic acid estimation was less sensitive 28.7%. Conclusion: In conclusion serum lactic acid is specific (100%) for fat embolism but not sensitive (28.7%). By using serum lactic acid level, development of fat embolism can’t be predicted however, elevated lactic acid level will help us in risk stratification.

Original languageEnglish
Pages (from-to)RC01-RC03
JournalJournal of Clinical and Diagnostic Research
Volume12
Issue number10
DOIs
Publication statusPublished - 01-10-2018
Externally publishedYes

Fingerprint

Fat Embolism
Lactic Acid
Fats
Serum
Femur
Blood
Bone Fractures
Bone
Tissue
Multiple Trauma
India
Statistical methods

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry

Cite this

Bhumireddy, Chandra Sekhar ; Kamath, Surendra Umesh ; Krishnamurthy, Sunil Lakshmipura. / Is serum lactic acid a reliable indicator for diagnosing fat embolism syndrome?. In: Journal of Clinical and Diagnostic Research. 2018 ; Vol. 12, No. 10. pp. RC01-RC03.
@article{72fc6cbcfe8b43d0a2c891c90d00c83d,
title = "Is serum lactic acid a reliable indicator for diagnosing fat embolism syndrome?",
abstract = "Introduction: The incidence of Fat Embolism Syndrome (FES) has been reported to occur in 0.5 to 3{\%} of patients with isolated long bone fracture. FES is most commonly associated with long bone fractures, if associated with polytrauma then the chance of manifestation increases by 11{\%}. Fat embolism is a clinical entity diagnosed mainly by Gurd’s criteria which includes clinical signs and blood parameters. There is no single blood parameter to detect FES at earliest. A high lactate level is an early sign of tissue hypoxia. In patients with femur shaft fracture tissue hypoxia is the most important cause of increased lactate levels. Increased blood lactate level is related to increased mortality. Aim: To establish the relationship between serum lactic acid and fat embolism in patients with fracture shaft of the femur. Materials and Methods: The present was a prospective study done at Kasturba Medical College Hospitals, Mangalore, Karnataka, India, on 40 patients with femur shaft fracture. Statistical analysis was done using SPSS (version 17.0). Results: In the present study, four patients out of 40 had FES (Gurd’s criteria), whose serum lactic acid was high (>25) within 72 hours of injury. Fourteen patients had elevated lactic acid (>20) but did not develop FES. All patients with FES had elevated serum lactic acid which was statistically significant (p-value 0.003), yet serum lactic acid estimation was less sensitive 28.7{\%}. Conclusion: In conclusion serum lactic acid is specific (100{\%}) for fat embolism but not sensitive (28.7{\%}). By using serum lactic acid level, development of fat embolism can’t be predicted however, elevated lactic acid level will help us in risk stratification.",
author = "Bhumireddy, {Chandra Sekhar} and Kamath, {Surendra Umesh} and Krishnamurthy, {Sunil Lakshmipura}",
year = "2018",
month = "10",
day = "1",
doi = "10.7860/JCDR/2018/35705.12161",
language = "English",
volume = "12",
pages = "RC01--RC03",
journal = "Journal of Clinical and Diagnostic Research",
issn = "2249-782X",
publisher = "Journal of Clinical and Diagnostic Research",
number = "10",

}

Is serum lactic acid a reliable indicator for diagnosing fat embolism syndrome? / Bhumireddy, Chandra Sekhar; Kamath, Surendra Umesh; Krishnamurthy, Sunil Lakshmipura.

In: Journal of Clinical and Diagnostic Research, Vol. 12, No. 10, 01.10.2018, p. RC01-RC03.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Is serum lactic acid a reliable indicator for diagnosing fat embolism syndrome?

AU - Bhumireddy, Chandra Sekhar

AU - Kamath, Surendra Umesh

AU - Krishnamurthy, Sunil Lakshmipura

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Introduction: The incidence of Fat Embolism Syndrome (FES) has been reported to occur in 0.5 to 3% of patients with isolated long bone fracture. FES is most commonly associated with long bone fractures, if associated with polytrauma then the chance of manifestation increases by 11%. Fat embolism is a clinical entity diagnosed mainly by Gurd’s criteria which includes clinical signs and blood parameters. There is no single blood parameter to detect FES at earliest. A high lactate level is an early sign of tissue hypoxia. In patients with femur shaft fracture tissue hypoxia is the most important cause of increased lactate levels. Increased blood lactate level is related to increased mortality. Aim: To establish the relationship between serum lactic acid and fat embolism in patients with fracture shaft of the femur. Materials and Methods: The present was a prospective study done at Kasturba Medical College Hospitals, Mangalore, Karnataka, India, on 40 patients with femur shaft fracture. Statistical analysis was done using SPSS (version 17.0). Results: In the present study, four patients out of 40 had FES (Gurd’s criteria), whose serum lactic acid was high (>25) within 72 hours of injury. Fourteen patients had elevated lactic acid (>20) but did not develop FES. All patients with FES had elevated serum lactic acid which was statistically significant (p-value 0.003), yet serum lactic acid estimation was less sensitive 28.7%. Conclusion: In conclusion serum lactic acid is specific (100%) for fat embolism but not sensitive (28.7%). By using serum lactic acid level, development of fat embolism can’t be predicted however, elevated lactic acid level will help us in risk stratification.

AB - Introduction: The incidence of Fat Embolism Syndrome (FES) has been reported to occur in 0.5 to 3% of patients with isolated long bone fracture. FES is most commonly associated with long bone fractures, if associated with polytrauma then the chance of manifestation increases by 11%. Fat embolism is a clinical entity diagnosed mainly by Gurd’s criteria which includes clinical signs and blood parameters. There is no single blood parameter to detect FES at earliest. A high lactate level is an early sign of tissue hypoxia. In patients with femur shaft fracture tissue hypoxia is the most important cause of increased lactate levels. Increased blood lactate level is related to increased mortality. Aim: To establish the relationship between serum lactic acid and fat embolism in patients with fracture shaft of the femur. Materials and Methods: The present was a prospective study done at Kasturba Medical College Hospitals, Mangalore, Karnataka, India, on 40 patients with femur shaft fracture. Statistical analysis was done using SPSS (version 17.0). Results: In the present study, four patients out of 40 had FES (Gurd’s criteria), whose serum lactic acid was high (>25) within 72 hours of injury. Fourteen patients had elevated lactic acid (>20) but did not develop FES. All patients with FES had elevated serum lactic acid which was statistically significant (p-value 0.003), yet serum lactic acid estimation was less sensitive 28.7%. Conclusion: In conclusion serum lactic acid is specific (100%) for fat embolism but not sensitive (28.7%). By using serum lactic acid level, development of fat embolism can’t be predicted however, elevated lactic acid level will help us in risk stratification.

UR - http://www.scopus.com/inward/record.url?scp=85053143749&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053143749&partnerID=8YFLogxK

U2 - 10.7860/JCDR/2018/35705.12161

DO - 10.7860/JCDR/2018/35705.12161

M3 - Article

VL - 12

SP - RC01-RC03

JO - Journal of Clinical and Diagnostic Research

JF - Journal of Clinical and Diagnostic Research

SN - 2249-782X

IS - 10

ER -