Fat Embolism Syndrome: Evolving Perspectives on Diagnosis and Care

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Fat embolism syndrome (FES) is a rare clinical entity. Fat embolization in patients with trauma and long-bone fractures occurs in a majority of patients, and only a few patients develop the triad of skin petechia, respiratory distress, and neurological disturbances, which are termed FES. The exact incidence is not known, as there are no definitive criteria. All English-language publications about FES were searched and reviewed using Google Scholar, PubMed, various databases, conference proceedings, and abstracts, which were included in this study. FES is particularly underdiagnosed and underreported in body contour plastic surgery patients. The following two main theories of FES pathophysiology are proposed: mechanical and biochemical. There are various risk factors for FES, mainly in young patients and bilateral femoral fractures. The diagnosis of FES was traditionally a diagnosis of exclusion. Recently, the combination of clinical parameters and imaging studies has increased the accuracy of FES diagnosis. Point-of-care ultrasound can show fat particles floating from the inferior vena cava to the right heart. MRI is more specific in diagnosing FES with brain involvement. A high index of suspicion, combined with early imaging studies and the application of clinical criteria, must be used to diagnose FES early and accurately. Pharmacological treatments, ranging from ethanol to a

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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