{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T20:38:33Z","timestamp":1791664713881,"version":"4.3.4"},"reference-count":40,"publisher":"Portland Press Ltd.","issue":"6","content-domain":{"domain":["portlandpress.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2007,9,1]]},"abstract":"<jats:p>FES (fat embolism syndrome) is a clinical problem, and, although ARDS (acute respiratory distress syndrome) has been considered as a serious complication of FES, the pathogenesis of ARDS associated with FES remains unclear. In the present study, we investigated the clinical manifestations, and biochemical and pathophysiological changes, in subjects associated with FES and ARDS, to elucidate the possible mechanisms involved in this disorder. A total of eight patients with FES were studied, and arterial blood pH, PaO2 (arterial partial pressure of O2), PaCO2 (arterial partial pressure of CO2), biochemical and pathophysiological data were obtained. These subjects suffered from crash injuries and developed FES associated with ARDS, and each died within 2\u00a0h after admission. In the subjects, chest radiography revealed that the lungs were clear on admission, and pulmonary infiltration was observed within 2\u00a0h of admission. Arterial blood pH and PaO2 declined, whereas PaCO2 increased. Plasma PLA2 (phospholipase A2), nitrate\/nitrite, methylguanidine, TNF-\u03b1 (tumour necrosis factor-\u03b1), IL-1\u03b2 (interleukin-1\u03b2) and IL-10 (interleukin-10) were significantly elevated. Pathological examinations revealed alveolar oedema and haemorrhage with multiple fat droplet depositions and fibrin thrombi. Fat droplets were also found in the arterioles and\/or capillaries in the lung, kidney and brain. Immunohistochemical staining identified iNOS (inducible nitric oxide synthase) in alveolar macrophages. In conclusion, our clinical analysis suggests that PLA2, NO, free radicals and pro-inflammatory cytokines are involved in the pathogenesis of ARDS associated with FES. The major source of NO is the alveolar macrophages.<\/jats:p>","DOI":"10.1042\/cs20070011","type":"journal-article","created":{"date-parts":[[2007,8,14]],"date-time":"2007-08-14T08:40:39Z","timestamp":1187080839000},"page":"279-285","update-policy":"https:\/\/doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Clinical and pathological features of fat embolism with acute respiratory distress syndrome"],"prefix":"10.1042","volume":"113","author":[{"given":"Shang\u00a0Jyh","family":"Kao","sequence":"first","affiliation":[{"name":"Division of Chest Medicine, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan"},{"name":"School of Respiratory Therapy, Taipei Medical University and Fu-Jen Catholic Medical College, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana\u00a0Yu-Wung","family":"Yeh","sequence":"additional","affiliation":[{"name":"Division of Chest Medicine, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan"},{"name":"School of Respiratory Therapy, Taipei Medical University and Fu-Jen Catholic Medical College, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsing\u00a0I.","family":"Chen","sequence":"additional","affiliation":[{"name":"Institute of Integrative Physiology and Clinical Sciences, Tzu Chi University, Hualien, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"288","published-online":{"date-parts":[[2007,8,13]]},"reference":[{"key":"2021120120460500300_B1","doi-asserted-by":"crossref","first-page":"S59","DOI":"10.1016\/j.injury.2006.08.041","article-title":"Prevention of fat embolism syndrome","volume":"37","author":"White","year":"2006","journal-title":"Injury"},{"key":"2021120120460500300_B2","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/j.injury.2006.08.035","article-title":"Fat embolism syndrome: history, definition, epidemiology","volume":"37","author":"Talbot","year":"2006","journal-title":"Injury"},{"key":"2021120120460500300_B3","first-page":"507","article-title":"Fat embolism syndrome","volume":"31","author":"Parisi","year":"2002","journal-title":"Am. 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