Multiorgan dysfunction due to traumatic fat embolism syndrome: Critical care and perioperative issues

Abstract

Fat embolism is the presence of fat droplets within the circulation following trauma with or without clinical sequel. Fat embolism syndrome (FES) is a rare, but serious sequel of fat embolism usually occurring within 24 h of trauma and mostly causing petechial rashes, respiratory insufficiency, and central nervous system dysfunction. We report a young male who developed clinical FES while awaiting surgery for definitive fixation of bilateral closed tibial fracture following initial stabilization with long leg slab, was treated in the intensive care unit and underwent internal fixation under epidural anesthesia after clinical improvement. FES is a multisystem disorder with variable clinical presentation. Timely organ support improves prognosis. Epidural anesthesia can be a safe option for definitive fixation of lower limb fractures after improvement of organ dysfunctions.