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