Respiratory failure after total hip replacement - Journal of
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An 82 year old woman fractured her right hip after a fall. A total hip replacement was performed. The operation proceeded uneventfully; however, upon drilling for medullary pin placement, the patient became hemodynamically unstable and was transferred to the intensive care unit postoperatively.

Case Report:
The patient was hypotensive, despite treatment with high vasopressor doses. Blood examination showed thrombocytopenia and prolonged clotting time. Subsequently, she became severely hypoxic and developed pulseless electrical activity, but regained cardiac output after cardiopulmonary resuscitation. Transthoracic echocardiography showed a dilated right atrium, increased rightward pressure and diastolic bulging. The patient rapidly developed irreversible obstructive shock. Supportive care was therefore discontinued, after which the patient passed away. During autopsy, extensive intrapulmonary abnormalities were observed: indicating that the capillaries contained fat cells. Our patient died from a fat embolism...

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