Assessment and management of fat embolism

Abstract

Fat embolism syndrome is a complication of a range of conditions. It is hard to prevent, difficult to diagnose, and there is no specific effective treatment. The syndrome is composed of respiratory, haematological, neurological, and cutaneous symptoms and signs associated with trauma, in particular long bone fractures, and other disparate surgical and medical conditions. It most commonly follows orthopaedic surgery, but can also follow liposuction and medical conditions, as disparate as cardiopulmonary resuscitation and sickle cell disease are possible precipitants. The pathogenesis is still debated. It is clear that while fat emboli occur quite commonly, the clinical syndrome with respiratory, neurological, and other sequelae is rare. Diagnosis is by pattern recognition, but recently characteristic features seen on cerebral magnetic resonance imaging can be used to increase the probability of the diagnosis. Various therapeutic options have been tried and failed and treatment is currently supportive.