fat embolism syndrome

Fat Embolism Syndrome (FES)

potentially fatal complication of long bone fractures
classically described as the triad of hypoxia, petechiae, and neurological impairment
characterized by bone marrow fat entering the systemic circulation and the individual's inflammatory response to it
- response can result in dysfunction of several organs, most importantly the lungs, brain, and skin
although fat embolization occurs in the majority of patients with long bone fractures or during orthopedic procedures, clinical signs and symptoms occur in only 1-10% of these patients
- most of the reported cases occurred in patients with multiple traumatic injuries that resulted in the systemic inflammatory response syndrome, which causes multi-organ damage via a reaction to free fatty acids
- non-traumatic causes of FES
  - non-traumatic conditions are very uncommon causes of FES; they are acute pancreatitis, fatty liver, corticosteroid therapy, lymphography, fat emulsion infusion and haemoglobinopathies

Reference:

Gurd AR, Wilson RI. The fat embolism syndrome. J Bone Joint Surg (Br) 1974;7:408-416.
Robinson CM. Current concepts of respiratory insufficiency syndromes after fracture. J Bone Joint Surg (Br) 2001;7:781-791.
Shaikh N. Emergency management of fat embolism syndrome. J Emerg Trauma Shock. 2009 Jan;2(1):29-33.

Last reviewed 01/2018

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