16 Fat Embolism

FAT EMBOLISM

  • Fat Embolism Syndrome is an acute respiratory disorder caused by an inflammatory response to embolized fat globules that may enter the bloodstream as a result of acute long bone fractures or intramedullary instrumentation. Patients present with hypoxia, changes in mental status, and  petechial rash. 
  • Diagnosis is made clinically with presence of hypoxemia (PaO2 < 60), CNS depression, petechial rash, and pulmonary edema.
  • Treatment is focused on prevention with early stabilization of long bone fractures. Mechanical ventilation with high levels of PEEP is the recommended treatment for acute presentation. 

Gurd and Wilson / modified Gurd’s criteria to aid in making diagnosis:

Reference:

  1. https://www.orthobullets.com/basic-science/9055/fat-embolism-syndrome
  2. Scarpino, M. & Lanzo, Giovanni & Lolli, Francesco & Grippo, Antonello. (2019). From the diagnosis to the therapeutic management: Cerebral fat embolism, a clinical challenge. International Journal of General Medicine. Volume 12. 39-48. 10.2147/IJGM.S177407.