Sequential changes in gas exchange following traumatic fat embolism

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We present a young man who developed fat embolism syndrome following a fractured femoral shaft. By intermittently measuring oxygen saturation with a pulse oximeter and varying the inspired partial pressure of oxygen we were able to quantify the development of shunt and ventilation/perfusion (V/Q) mismatch over the course of his illness. Shunt and low V/Q gradually improved in the week following admission but deteriorated following general anaesthesia for nailing of the femur.

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