https://wikianesthesia.org/w/index.php?action=history&feed=atom&title=Fat_embolismFat embolism - Revision history2026-05-05T10:10:06ZRevision history for this page on the wikiMediaWiki 1.37.1https://wikianesthesia.org/w/index.php?title=Fat_embolism&diff=16368&oldid=prevJVD: Created this, text from OpenAnesthesia2024-04-08T15:34:12Z<p>Created this, text from OpenAnesthesia</p>
<p><b>New page</b></p><div>{{Infobox comorbidity<br />
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Provide a brief summary of this comorbidity here.<br />
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== Anesthetic implications<!-- Briefly summarize the anesthetic implications of this comorbidity. --> ==<br />
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=== Preoperative optimization<!-- Describe how this comorbidity may influence preoperative evaluation and optimization of patients. --> ===<br />
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=== Intraoperative management<!-- Describe how this comorbidity may influence intraoperative management. --> ===<br />
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=== Postoperative management<!-- Describe how this comorbidity may influence postoperative management. --> ===<br />
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== Related surgical procedures<!-- List and briefly describe any procedures which may be performed specifically to treat this comorbidity or its sequelae. If none, this section may be removed. --> ==<br />
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== Pathophysiology<!-- Describe the pathophysiology of this comorbidity. Add subsections as needed. --> ==<br />
Fat embolism syndrome (FES) is a physiologic response to fat embolism. While fat embolization is quite common, likely occurring in nearly all patients with a femoral or pelvic fracture, fat embolization syndrome occurs in less than 1% of these patients. FES may develop over 12-72 hours or may present as fulminant disease with respiratory failure and cardiac arrest. A diagnosis based on the Gurd diagnostic criteria requires the presence of fat microemboli in the blood along with 1 major (respiratory insufficiency, cerebral involvement, or petechial rash) plus 4 minor criteria (pyrexia, tachycardia, retinal changes, jaundice, or renal changes). <br />
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== Signs and symptoms<!-- Describe the signs and symptoms of this comorbidity. --> ==<br />
A petechial rash is considered pathognomonic for the syndrome and can be seen on conjunctiva, oral mucosa, and skin folds. Although mild hypoxia is common, less than 10% of patients with FES develop acute respiratory distress syndrome (ARDS). The pathophysiology of FES likely involves both the obstruction of end-organ capillaries by microemboli along with a systemic inflammatory response. Large emboli may cause segmental wall motion abnormalities, elevated pulmonary artery pressures, right ventricular dysfunction, and cardiac arrest.<br />
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== Diagnosis<!-- Describe how this comorbidity is diagnosed. --> ==<br />
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== Treatment<!-- Summarize the treatment of this comorbidity. Add subsections as needed. --> ==<br />
Treatment of fat embolism syndrome consists of supportive care and early resuscitation with prompt supplemental oxygen and intubation if necessary. <br />
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=== Medication<!-- Describe medications used to manage this comorbidity. --> ===<br />
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=== Surgery<!-- Describe surgical procedures used to treat this comorbidity. --> ===<br />
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=== Prognosis<!-- Describe the prognosis of this comorbidity --> ===<br />
Most symptoms resolve within 3-7 days. <br />
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== Epidemiology<!-- Describe the epidemiology of this comorbidity --> ==<br />
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== References ==<br />
Schonfeld SA, Ploysongsang Y, DiLisio R, et al. Fat embolism prophylaxis with corticosteroids. A prospective study in high-risk patients. Ann Intern Med. 1983;99(4):438-443. doi:10.7326/0003-4819-99-4-438 <br />
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Gurd AR, Wilson RI. The fat embolism syndrome. J Bone Joint Surg Br. 1974;56B(3):408-416. <br />
[[Category:Comorbidities]]</div>JVD