Treatment
The mainstay of treatment is supportive, including sufficient
oxygenation and fluid resuscitation with maintaining good intravascular
volume, as shock can exacerbate lung injury. Albumin has been
recommended for volume resuscitation in addition to balanced electrolyte
solution, because it not only restores blood volume but also binds with
the fatty acids and may decrease the extent of lung injury. There are no
drugs that have proved to give better outcome. Some data support the
prophylactic administration of corticosteroids to patients with an
elevated risk of FES, by decreasing the body’s inflammatory response to
the embolisms, thus supporting the biochemical
theory.17,18 There is no consensus about the dosage
and duration of the prophylactic corticosteroid therapy. Furthermore,
there is no current evidence supporting the benefits of corticosteroids
administered following a diagnosis of FES.17,18 Recent
experimental studies on the renin-angiotensin pathway are promising,
angiotensin II acts as a vasoconstrictor but also proinflammatory and
profibrotic. Patients in a state of alcoholic intoxication had less
incidence of FES than sober ones, however there have been no prospective
studies on use of alcohol as a drug for FES.18