The early diagnosis and treatment of fat embolism syndrome: a preliminary report.

Abstract

A method of identifying stained neutral fat droplets in rapidly-frozen clotted blood as indication of the presence or development of fat embolism syndrome was evaluated. In seven patients with a clinical diagnosis of fat embolism syndrome who were studied with a Cryostat technique neutral fat was demonstrated in their sectioned clots. Of 16 patients with serious fat embolism-prone fracture trauma, ten had positive sections and six did not. None of the six patients without fat in their clots went on to develop the syndrome. Seven of the ten patients with positive sections were initially treated with steroids and none developed the clinical syndrome. Of the three patients with positve sections who were not initially treated with steroids, two developed typical fat embolism syndrome after a latent period. These findings suggest that detection of stainable fat droplets in rapidly-frozen sectioned clot may be useful in predicting trauma patients at risk for developing fat embolism syndrome, and treatment of these high-risk patients with corticosteroids from the very beginning may prevent the clinical expression of the disorder.