Fat Embolism Syndrome – A Qualitative Review of its Incidence, Presentation, Pathogenesis and Management

Abstract

Fat Embolism Syndrome (FES) is a poorly defined clinical phenomenon which has been attributed to fat emboli entering the circulation. It is common, and its clinical presentation may be either subtle or dramatic and life threatening. This is a review of the history, causes, pathophysiology, presentation, diagnosis and management of FES. FES mostly occurs secondary to orthopaedic trauma; it is less frequently associated with other traumatic and atraumatic conditions. There is no single test for diagnosing FES. Diagnosis of FES is often missed due to its subclinical presentation and/or confounding injuries in more severely injured patients. FES is most frequently diagnosed using the Gurd and Wilson criteria, like its rivals it is not clinically validated. Although FES is a multi-system condition, its effects in the lung, brain, cardiovascular system and skin cause most morbidity. FES is mostly a self-limiting condition and treatment is supportive in nature. Many treatments have been trialled, most notably corticosteroids and heparin, however no validated treatment has been established.

Fat embolism Syndrome: Is it common in smokers

“…Although pulmonary fat embolization occurs in almost all patients with long-bone fractures [1,4,6] , only 1% to 30% of patients develop the full clinical fat embolism syndrome that consists of petechial rash, diffuse pulmonary infiltrates, hypoxemia, confusion, pyrexia, tachycardia, and tachypnea, 24 to 48 hours after trauma [3,5,7] . Fat embolism syndrome can be due to trauma as well as non trauma related causes.…”

“…Incidence of fat embolism syndrome in long bone fractures rangesfrom 0.9% to as high as 33% in various studies. Whereas fat embolism is seen in upto 82% of trauma cases [3][4][5][6] . There are several causes that can be attributed to fat embolism.…”