Review article CURRENT CONCEPTS OF RESPIRATORY INSUFFICIENCY SYNDROMES AFTER FRACTURE

Episodes of hypoxia and acute respiratory insufficiency often occur after orthopaedic trauma.1,2 Most patients who have sustained a major injury to the pelvis or a long bone are monitored using pulse oximetry, and the onset of respiratory symptoms is usually presaged by episodes of desaturation.3 The reason for the hypoxia is often apparent after careful clinical assessment (Table I), and it is usually reversible by the administration of oxygen and treatment of the precipitating cause. In a few patients, however, the cause of the deterioration in respiratory function is not obvious or easily correctible and demands more sophisti-cated investigation. In these, the onset of hypoxia may be associated simultaneously with the development of dys-function of other vital organs. The terms fat embolus syndrome (FES) and acute (or adult) respiratory distres