Post-traumatic Fat Embolism in Intensive Care

Abstract

Fat embolism syndrome (FES) is a group of clinical, biological and radiological symptoms resulting from obstruction of the microcirculatory network by microdroplets of insoluble fat. It is a complication most often observed in the aftermath of a polytrauma involving several long bone fractures, but it can also occur outside the traumatic context. The aim of this study was to examine the epidemiological, pathogenic, clinical, paraclinical, therapeutic and evolutionary aspects of fat embolism syndrome. This was a retrospective study including all cases of post-traumatic fat embolism collected in the surgical intensive care unit of the Chu Ibn Rochd in Casablanca over a period of 5 years. 24 cases of post-traumatic fat embolism were collected. Male sex, age less than 40 years and the presence of a femur fracture were the dominant characteristics of the epidemiological profile of the trauma patient presenting with this syndrome occurring mainly within 72 hours of the trauma. The clinico-biological presentation was dominated by respiratory distress, consciousness disorders, anaemia, thrombocytopenia and hypocholesterolaemia. The management of FES was symptomatic, combining early immobilisation of fracture sites, optimal analgesia and maintenance of an effective blood volume. 41.66% of patients required mechanical ventilation and 75% underwent osteosynthesis of their fracture sites. 25% developed ARDS and the mortality rate was 26.08%.