Fat embolism after intraosseous catheters in pediatric forensic autopsies.

Details

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_BC3762C93F27
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Fat embolism after intraosseous catheters in pediatric forensic autopsies.
Journal
International journal of legal medicine
Author(s)
Castiglioni C., Carminati A., Fracasso T.
ISSN
1437-1596 (Electronic)
ISSN-L
0937-9827
Publication state
Published
Issued date
05/2023
Peer-reviewed
Oui
Volume
137
Number
3
Pages
787-791
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
In our center, we performed the autopsy of a child who died from drowning and presented, at autopsy, a major pulmonary fat embolism (PFE). A cardiopulmonary resuscitation (CPR) was performed, including infusion by intraosseous catheter (IIC). No other traumatic lesions and diseases classically related to a risk of PFE were detected. According to some animal studies, we considered the IIC as the only possible cause for PFE. However, we could not find literature to confirm this hypothesis in humans, especially in a pediatric population. To verify the occurrence of PFE after IIC in a pediatric population, we retrospectively selected 20 cases of pediatric deaths autopsied in our center, in which a CPR was performed, without bone fractures or other possible causes of PFE: 13 cases with IIC (group A) and 7 cases without IIC (group B). Several exclusion criteria were considered. The histology slides of the pulmonary tissue were stained by Oil Red O. PFE was classified according to the Falzi scoring system. In group A, 8 cases showed PFE: 4 cases with a score 1 of Falzi and 4 cases with a score 2 of Falzi. In group B, no case showed PFE. The difference between the two groups was statistically significant. The results of our study seem to confirm that IIC can lead to PFE in a pediatric population and show that the PFE after IIC can be important (up to score 2 of Falzi). To the best of our knowledge, our study is the first specifically focused on the occurrence of PFE after IIC in a pediatric population by using autoptic data.
Keywords
Humans, Child, Autopsy, Retrospective Studies, Pulmonary Embolism/pathology, Embolism, Fat/pathology, Drowning, Catheters/adverse effects, Intraosseous catheters, Pediatric resuscitation, Pulmonary fat embolism
Pubmed
Web of science
Open Access
Yes
Create date
01/07/2022 13:43
Last modification date
16/09/2023 6:15
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