FAT EMBOLISM

DESCRIPTION

A fat embolism (FE) is a piece of intravascular fat that lodges within a blood
vessel and causes a blockage of blood flow. Fat emboli commonly occur after fractures to
the long bones of the lower body, particularly the femur (thighbone), tibia (shinbone),
and pelvis.

While fat emboli are common and generally resolve on their own, they can lead to a
serious condition called fat embolism syndrome (FES). FES can cause inflammation,
multi-organ dysfunction, and neurological changes that can be deadly.

Symptoms
12 to 72 hours Trusted Sourceafter trauma. Symptoms tend to occur throughout the

body and include:

 rapid breathing

 shortness of breath

 mental confusion

 lethargy

 coma

 pinpoint rash (called a petechial rash), often found on the chest, head, and neck
area, which occurs due to bleeding under the skin

 fever

 anemia

DIAGNOSIS

There is no one test that can definitively diagnose FES. Despite the presence of fat
emboli, imaging tests can look normal. As such, doctors typically rely on a physical
examination, medical history (taking into account any recent history of broken bones),
and what is known as Gurd’s criteria.

Gurd’s major criteria include:

 petechial rash

 respiratory distress

 mental concussion

Gurd’s minor criteria include:

 fat in the blood

  fever

 jaundice

 anemia

 fast heartbeat

 renal dysfunction

If a person has at least one of Gurd’s major criteria and at least four minor criteria, a
diagnosis can comfortably be made.

MEDICAL MANAGEMENT/ TREATMENT

Treatment for FES generally revolves around supportive care. You’ll be admitted
to the hospital, most likely to the intensive care unit. Your oxygen levels will be
monitored and you may be given oxygen, if needed. Some people will need help
breathing with mechanical ventilation. You may also receive intravenous fluids and
drugs that will increase blood volume. This helps remove damaging free fatty acids from
the body.

Your doctor may prescribe steroids and the blood thinner heparin, but these drugs have
not been proven to be highly effective. Their use has to be carefully monitored.