Treatment

Treatment is supportive in the expectation that in time recovery will occur spontaneously.

Early immobilisation of fractures is recommended as this reduces the risk of FES and adequate volume replacement with blood or colloid is important since in animal models shock has been shown to increase susceptibility to FES.

High flow rate oxygen is given to maintain the arterial oxygen tension in the normal range.

Maintenance of intravascular volume is important

• because shock can exacerbate the lung injury caused by FES

Human albumin has been advocated for volume replacement because of its ability to bind FFA's. Adequate analgesia is also important in reducing the rise in FFA's attributable to an increased sympathoadrenal response

• albumin has been recommended for volume resuscitation in addition to balanced electrolyte solution
  • not only restores blood volume but also binds with the fatty acids and may thus decrease the extent of lung injury

Respiratory support requirements range from face mask oxygen to artificial ventilation with PEEP.

• mechanical ventilation and PEEP may be required to maintain arterial oxygenation

Medications, including steroids, heparin, alcohol, and dextran, have been found to be ineffective (1).

Reference:

• Shaikh N. Emergency management of fat embolism syndrome. J Emerg Trauma Shock. 2009 Jan;2(1):29-33.