Jinshan Hospital's Emergency and Critical Care Center successfully saved the life of a young man who suddenly fell into unconsciousness after a fracture.
Recently, a young man in his 20s suddenly lost consciousness after a fracture. The Emergency and Critical Care Center of Jinshan Hospital Affiliated to Fudan University provided precise treatment and eventually managed to save his life from the hands of death.
Xiao Zhang was injured in the thigh due to a car accident and was initially diagnosed with bilateral femoral fractures. After being admitted to the orthopedic department of Jinshan Hospital, his basic condition was good. The orthopedic team made preoperative preparations and actively treated him. Just when everything was ready, Xiao Zhang suddenly had difficulty breathing, his heart rate increased, and he quickly fell into unconsciousness. His blood oxygen saturation dropped sharply, from 98% to 40% in less than 10 minutes. His heart rate also rose to 170 beats/minute. The ECG monitor kept sounding the alarm, and his young life was hanging by a thread.
The emergency and critical care center team immediately started emergency treatment for Xiao Zhang and quickly stabilized his basic vital signs, but the cause of his deteriorating condition has not yet been found and the crisis is far from over. After excluding common causes, the treatment team actively conducted multidisciplinary consultations to jointly explore treatment options. Combining the results of various examinations, experts quickly suspected the dangerous "fat embolism syndrome".
To make a clear diagnosis, the expert team quickly contacted the laboratory, and about half an hour later, they found clusters of fat particles in the patient's urine, and the next morning, they also found fat particles in the blood sample. The final diagnosis confirmed the previous conjecture.
Experts say the so-called "fat embolism syndrome" is a serious complication of fractures. Fat droplets in the bone marrow enter the blood circulation through the broken bones, blocking the blood vessels of the lungs, brain and other important organs, threatening the patient's life. The mortality rate of patients with severe fat embolism is even more than 50%. There is currently no effective treatment.
The patient's blood oxygen saturation suddenly decreases again and again because fat particles in the body are released into the blood again and again, causing microthrombosis in the pulmonary artery and affecting gas exchange.
In order to control the disease as soon as possible, Professor Shen Jie, director of the Emergency and Critical Care Center of Jinshan Hospital, developed a comprehensive treatment plan: first, give high-dose hormone shock therapy to reduce inflammatory reactions; use immunoglobulins to improve the patient's immunity and enhance the body's resistance; perform tracheotomy and ventilator-assisted ventilation, deep sedation and muscle relaxation to control ventilation, and supplement with PEEP titration and lung protective ventilation strategies to maintain respiratory function and oxygen supply in the body; at the same time, perform bronchoalveolar lavage with fiberoptic bronchoscopy to remove the infected lesions in the lungs; to better understand the circulatory function, the doctor also implanted a PICCO catheter to monitor hemodynamic parameters, monitor cardiac output and extravascular lung water 4 times a day, and guide the use of drugs. The ECMO team is also ready to provide protection in critical moments.
After 10 days of hard work, we finally saw the light of hope. With the meticulous, complete and powerful "combination punch", the disease finally retreated, Xiao Zhang's condition gradually stabilized, his blood oxygen saturation gradually increased, and he could be taken off the ventilator. After reducing the dosage of sedatives, the patient's consciousness gradually recovered, and all indicators tended to stabilize.
Subsequently, the orthopedic team successfully performed a femoral fracture surgery on the patient and provided postoperative rehabilitation treatment and care. Three days later, Xiao Zhang was out of danger and transferred to a general ward for follow-up treatment. He could walk smoothly. His family could not help but express their gratitude, "Thanks to the careful treatment of the expert team, the child was able to escape the gates of hell and regain a new life!"
