Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Systemic
Abstract number: 23790
IS THERE ANY ROLE OF INHALATIONAL STEROIDS IN PROPHYLAXIS OF
POST TRAUMATIC FAT EMBOLISM SYNDROME???
AMIT AGARWAL 1 , ramesh SEN 2 , SAMEER AGARWAL 2 , sujit TRIPATHY 2
1 AIIMS, NEW DELHI (INDIA), 2 PGIMER, CHANDIGARH (INDIA)
As fat embolism syndrome is primarily a lung parenchymal disorder, it is expected
that inhaled corticosteroids (Ciclesonide aerosol) given as prophylaxis may prevent
the development of hypoxemia or Fat Embolism syndrome in patients at high risk for
this complication. 40 cases of polytrauma patients presenting within 8 hours of
injury were randomly allocated in one of the two groups. In group 1 ciclesonide
640mcg was given with a metered dose inhaler and repeated once again after 24
hours whereas group 2 was taken as control and observed for 72 hours for any
episode of hypoxia by serial arterial blood gas monitoring along with haemogram,
serum biochemistry, plasma lactate, platelet count, coagulogram and chest x-ray.
The outcome was assessed using schonfeld?s criteria for the eventual outcome of
subclinical or clinical fat embolism syndrome. RESULTS- Out of 20 patients in each
group, 6 patients developed subclinical fat embolism syndrome whereas 3 from
ciclesonide prophylaxis group and 8 from controls developed clinical fat embolism
syndrome. There is no statistical significance found between the eventual outcomes
of subclinical or clinical fat embolism syndrome between the ciclesonide prophylaxis
and control group, although there was trend seen in the possible preventive efficacy
of inhalational steroid in the present study but it did not reach to the statistical
significant level. The prophylactic role of inhalational steroid in post traumatic
subclinical and clinical fat embolism syndrome is statistical insignificant in present
study.
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