What is Fat Embolism Syndrome & How is it Treated? | Causes, Signs, Symptoms and Diagnosis of Fat Embolism Syndrome

Fat embolism syndrome is a condition in which fat lodges within the blood vessels and causes blockage. It occurs mostly after a bone injury, as the fat surrounding the bone and the muscle gets into the blood vessel.

Mostly fat in the bloodstream resolves on its own with time. Sometimes it may cause a serious condition known as fat embolism syndrome.⁽¹⁾ It can lead to fatal inflammation, multiorgan dysfunction, and neurological changes.

Fat embolism syndrome has a good outcome as it can be treated easily if the doctors catch the condition early.⁽²⁾

Embolism is a blockage in the bloodstream. Fat embolism is a blockage of the bloodstream due to fat. Usually fat does not travel in the bloodstream. However, it can if any injury occurs especially a bone injury.

Fat in the bone marrow or near the bones breaks loose and gets into the damaged blood vessels. Also, some surgical procedures on the bones can cause a fat embolism.⁽²⁾

There are a few risk factors that may increase the risk of developing fat embolism syndrome, these include:

• Age: Younger age group people are more likely to be affected by this condition
• Having closed fracture
• Having multiple fractures

Also, there are a few conservative treatments such as casts and splints that do not involve surgery but surely do increase the likelihood of developing fat embolism syndrome.

In very rare cases, certain injury illnesses, or procedures may cause fat embolism, such as:

• Fatty liver disease
• Bone marrow biopsy
• Pancreatitis

The symptoms of fat embolism occur suddenly mostly 1-3 days after the injury. The warning signs of this condition include:

• Sudden difficulty in breathing
• Confusion or other neurological symptoms
• Broken blood vessels presented as rash on the chest or face

Other warning signs include:

• Rapid heart rate
• Fat in urine
• Fever
• Thrombocytopenia
• Change in the color of skin and eye

There is no test to diagnose fat embolism. A doctor can ask for imaging scans, blood work, urine examinations, and scans of the brain and head. Sometimes, the imaging test may show normal despite the presence of fat emboli.

The doctor relies on the medical history, physical examination, and Gurds’ criteria to diagnose the condition.

Gurd’s major criteria include:

• Petechial rash
• Respiratory distress
• Mental concussion

Gurd’s minor criteria include:

• Fast heartbeat
• Anemia
• Jaundice
• Fever
• Fat in the blood
• Renal dysfunction

If a person has at least one of Gurd’s major criteria and at least one of the Gurd’s minor criteria, the diagnosis of fat embolism syndrome can be made.

There is no specific treatment to reverse or cure the fat embolism syndrome. Supportive care is provided to help a person breathe until the embolism clears.

A person may need oxygen and also a ventilator in certain cases. Electrolytes and drug albumin may be prescribed to bind fat and help maintain blood volume.

There are also a few preventive strategies that may lower the risk of complications or death. The preventive strategies include:

• Blood oxygen monitoring may help detect fat embolism much early before the symptoms get severe.
• Giving early and aggressive treatment for long bone fractures.
• Give fluids to people experiencing fractures.
• Give methylprednisolone to people who are at more risk of developing fat embolism.

Fat embolism syndrome is a common complication of bone injury. Most people recover and may even not notice any symptoms. The symptoms experienced can be taken care of with prompt medical care.