Detection of fat emboli by transesophageal echocardiography:experimental and clinical study / 中华超声影像学杂志

ABSTRACT

Objective To observe the characterization of fat emboli in cardiac chamber in pig model and the patients undergoing total hip arthroplasty(THA) by transesophageal echocardiography(TEE). Methods Different dose of fatty liquid was injected slowly via the internal jugular vein. The changes of the image were observed by continuous TEE. The lethal dose of fat embolism was recorded. Twenty-two patients underwent TEE during THA. Gray scale and echo intensity of fat embolism in right atrium were studied quantitatively in varied periods of the operation. Results With the increase of fat liquid injected in pig model, the strong- echo particles in right atrium and ventricle became more and more, the imaging of the particles was from “moving star”, “shower-like” to “snow fluffy”, at last paradoxical fat embolism occurred when the dose of fat liquid was over 4 ml. The accumulated lethal dose of fat embolism was 15.8 ～ 27.8 ml.②Fat emboli appeared as strong- echo particles in right atrium were found in different period of THA. Average gray scale and echo intensity of emboli in right atrium were significantly higher in period B than in other periods during THA. Conclusions Fat emboli in cardiac chamber can be found sensitively by TEE. Intra-operative monitoring and quantitative analysis is helpful to identifying fat embolism syndrome.Paradoxical embolism is a reliable evidence of fat embolism syndrome.