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Continuing Education in Anaesthesia, Critical Care & Pain 2007 7(5):148-151; doi:10.1093/bjaceaccp/mkm027
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© The Board of Management and Trustees of the British Journal of Anaesthesia [2007]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Fat embolism

Amandeep Gupta, MB BS FRCA1 and Charles S. Reilly, MD FRCA2,
1 SpR in Anaesthesia Royal Hallamshire Hospital Sheffield UK
2 Professor of Anaesthesia and Honorary Consultant Anaesthetist University of Sheffield and Royal Hallamshire Hospital Sheffield Sheffield UK
Tel: +44 114 226 1087 Fax: +44 114 271 3771 E-mail: c.s.reilly@sheffield.ac.uk

Key Words: Fat embolism syndrome is a clinical diagnosis with non-specific/insensitive diagnostic tests. • A high index of suspicion is important to ensure diagnosis. • The classic triad of respiratory changes, neurological abnormalities, and petechial rash is not always present. • Treatment is supportive. • Prophylactic steroid therapy may be considered for patients at a high risk.

The first 150 words of the full text of this article appear below.

Although its original clinical description dates from 1873,1 fat embolism syndrome remains a diagnostic challenge for clinicians. The term fat embolism indicates the often asymptomatic presence of fat globules in the lung parenchyma and peripheral circulation after long bone or other major trauma. The majority (95%) of cases occur after major trauma. Fat embolism syndrome is a serious consequence of fat emboli producing a distinct pattern of clinical symptoms and signs. It is most commonly associated with fractures of long bones and the pelvis, and is more frequent in closed, rather than open, fractures. The incidence increases with the number of fractures involved. Thus, patients with a single long bone fracture have a 1–3% chance of developing the syndrome, but it has been reported in up to 33% of patients with bilateral femoral fractures.2 Fat embolism syndrome can also occur in relation to other trauma, for example, soft tissue injury, . . . [Full Text of this Article]


   Clinical presentation
 

   Pathogenesis
 
‘Mechanical’ fat embolism (mechanical theory)

Production of toxic intermediaries (biochemical theory)


   Diagnosis
 

   Treatment and prevention
 

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