[Possibilities of determining prognosis in the transformation of post-traumatic dyslipidemic coagulopathy into the clinical fat embolism syndrome]

Abstract

The clinical and laboratory retrospective and prospective study orientated to the observation of total posttraumatic response of the organisms to serious injuries (fractures of long bones of lower extremities, fractures of bones of pelvis, serious multiple injuries of body cavities associated with fractures) has concentrated hyperglobulaemia and at the same time also of disorders of blood coagulation. These in all three institutes on the verification of the significance of hyperglobulaemia, disorders of blood coagulation and persistent tachycardia. The analysis of the relations between the findings of fat hyperglobulaemia, disorders of coagulation and persistent tachycardia has made it possible to present a thesis which is very important from the practical viewpoint, and namely that the persistent tachycardia in case of in-patients is in fact a clinical reflection or manifestation, an equivalent, even of the incidence of fat studies concentrated on the syndrome of traumatic fat embolism (F. E.) were carried out within a uniform concept of "post-traumatic dyslipidemic coagulopathy - PDC". A statistically significant relation has been proved between the incidence of fat hyperglobulaemia and the incidence of persistent tachycardia. When identifying the relations between individual laboratory and clinical findings the authors have proceeded from a pre-requisite we have objectified before, and namely that fat hyperglobulaemia and disorders in blood coagulation contribute significantly to the development of the syndrome of post-traumatic fat embolism. The origin of persistent tachycardia which is motivated in patients with fractures of bones neither by the increase of temperature nor by any other pathophysiological circumstances, represents a turning point or a time limit between PDC as a latent pathological condition and PDC with clinical manifestations, being associated in the subclinical form only with persistent tachycardia or in the manifest form with other evident symptoms (including persistent tachycardia). It is then possible to use the symptom of an early and persistent tachycardia in the clinical practice for the prognostication of possibilities of unfavourable pathophysiological development of the subclinical form of fat embolism into the clinically manifest form of fat embolism.