Fat embolism syndrome (patient information)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Jinhui Wu, MD

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How do I know if I have fat embolism syndrome and what are the symptoms of fat embolism syndrome?

There is usually a latent period of 24 to 72 hours between injury and onset. The onset is then sudden. The usual symptoms include:

• Chest pain
• Tachypnoea, even breathlessness
• Fever
• Petechial rash
• Headache
• Restlessness
• Disorientation, confusion, seizures, stupor, even coma
• Renal dysfunction: Oliguria, haematuria, or anuria.

Who is at risk for fat embolism syndrome?

• Blunt trauma
• Acute pancreatitis
• Diabetes mellitus
• Burns
• Pathologic fractures
• Joint reconstruction
• Liposuction
• Cardiopulmonary bypass
• Decompression sickness
• Parenteral lipid infusion

How to know you have fat embolism syndrome?

• Lab tests: Fat globules free or in macrophages can be detected in urine, blood or sputum in patients with fat embolism. It is a low sensitivity test. A negative result does not exclude fat embolism.
• Blood gases: This test may demonstrate hypoxia, low pO2 (less than 8 kPa or 60 mmHg), and hypocapnia .
• Blood tests: Complete blood count (CBC) may show decreased platelets and haematocrit. Lipase level is elevated.
• Chest x-ray: This image in patients with fat embolism syndrome may show snow storm appearance, increased pulmonary markings and dilatation of the right side of the heart within 24-48 h of onset of clinical findings.
• Head CT: Diffuse white-matter petechial hemorrhages may be shown in patients with fat embolism. A normal CT finding can not exclude this disease. CT scan can also be used to rule out other causes for deterioration in consciousness level.
• Brain MRI scan: This test may help diagnose fat embolism in brain. It is more sensitive than CT scan and can diagnose earlier. This image may show typical white matter changes in the area of damaged vasculars.
• Transoesophageal echocardiography (TEE): This procedure may be used to assess intraoperative release of marrow contents into the bloodstream during intramedullary reaming and nailing.

When to seek urgent medical care?

Fat embolism syndrome is a severe syndrome. The onset is sudden. If you experience blunt trauma, cardiopulmonary bypass, acute pancreatitis, burns, fractures, joint reconstruction or liposuction, or have the history of diabetes mellitus, tell you doctor as soon as possible when the following symptoms appear:

• Chest pain
• Tachypnoea
• Fever
• Petechial rash
• Headache
• Any changes in consciousness such as restlessness, disorientation, confusion, seizures, or stupor
• Any changes in urine, such as oliguria, haematuria, or anuria.

Diseases with similar symptoms

• Pulmonary embolism
• Thrombotic thrombocytopenic purpura

Where to find medical care for fat embolism syndrome?

Directions to Hospitals Treating fat embolism syndrome

Copyleft Sources

http://emedicine.medscape.com/article/460524-overview

http://www.onlinejets.org/article.asp?issn=0974-2700;year=2009;volume=2;issue=1;spage=29;epage=33;aulast=Shaikh

http://www.patient.co.uk/doctor/Fat-Embolism.htm

http://www.medscape.com/viewarticle/564662_5