Page of

Rapid-Onset Coma and Chest X-Ray Whiteout After a Fracture 

Rapid-Onset Coma and Chest X-Ray Whiteout After a Fracture
Chapter:
Rapid-Onset Coma and Chest X-Ray Whiteout After a Fracture
Source:
Neurocritical Care (2 ed.)
Author(s):

Eelco F. M. Wijdicks

, Alejandro A. Rabinstein

, Sara E. Hocker

, and Jennifer E. Fugate

DOI:
10.1093/med/9780190602659.003.0029

Diffuse pulmonary infiltrates on chest X-ray and oxygen desaturation may indicate several acute conditions. How to differentiate neurogenic and cardiogenic pulmonary edema from aspiration and how to best treat these conditions initially is discussed in this chapter. Aspiration is more common, particularly after a seizure, vomiting, and difficult intubation. Clinical suspicion of acute pulmonary emboli is based on sudden oxygen desaturation with increased A-a gradient, but normal chest X-ray. Fat emboli should be considered in a patient with a recent major long bone fracture who develops sudden respiratory failure and neurological decline. Treatment may include broad-spectrum antibiotics (suspected aspiration), high positive end expiratory pressure (flash pulmonary edema), and repeated bronchoscopy.

Sign In

Copyright © 2022. All rights reserved.