Bronchoalveolar LavageinTrauma Patientsfor Diagnosis of FatEmbolism Syndrome

Fat embolism syndrome(FES) is a rare but serious compli cation occurring after long bone fractures. Presence of fat droplets in cells obtained by bronchoalveolar lavage has been proposed as a specific tool for FES diagnosis in trauma patients. We evaluated this technique over a 15-month period in 85 patients. Twenty-eight patients were excluded. The remaining 57 patients were divided into three groups: group 1, 26 patients without trauma as control; group 2,22 patients with trauma but without evidence of FES; and group 3, nine patients with trauma and evidence of FES. Sixof26 patients in group 1 and nine of22 patients in group 2 exhibited fat droplets in alveolar macrophages,whereas three of nine patients of group 3 had not. This study suggests that (1) presence of fat droplets in alveolar mac rophagesis not a reliable method for diagnosisof FES after long bone trauma, and (2) many conditions are associated with fat droplets in alveolar macrophages. (Chest 1992;102:1323-27)