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Definition of Fat embolism

A procedure by which fat tissue passes into the bloodstream and settles within a blood vessel. In general, an embolus is something that travels through the bloodstream, lodges in a blood vessel, and blocks it. A fat embolus is a fat particle or droplet that journeys through the circulation and finally blocks a blood vessel. Fat emboli tend to be small and multiple, causing numerous signs and symptoms.

Causes of Fat embolism

Around 90% of cases are related to trauma and fracture of or surgical procedure on a large bone, such as the femur bone of the thigh. As a result of the broken bone, the bone marrow fat escapes into the bloodstream. On the other hand, fat embolism can also ascend from parenteral lipid infusion (a form of nutritional supplementation), pancreatitis, burns, childbirth and other conditions. Although release of bone marrow fat into the circulation may be a cause, fat embolism may arise due to conditions such as widespread trauma or diseases that alter lipid metabolism in the body.

Symptoms of Fat embolism

Typically, fat embolism arises suddenly 12-36 hours after an injury. Symptoms and signs rest on the specific location of the blocked arteries. Signs and symptoms of fat embolus include central nervous system dysfunction that may progress to coma or death, irregularities in the heartbeat, respiratory distress, and fever. Anemia and thrombocytopenia (low platelet count) are common. Normally, small haemorrhages are seen on the neck, shoulders, armpits, and conjunctiva.

The mortality (death) rate is 10%-20%. Senior citizens and those with existing medical conditions or poor health have worse outcomes.

Diagnosis of Fat embolism

In order to diagnose fat embolism, your doctor will run the following tests on you:

  • Chest x-ray
  • Blood test
  • Urine test
  • Sputum test
  • Blood lipid levels
  • Serum lipase

Treatment of Fat embolism

Precise medical treatment for fat embolism and fat embolism syndrome (FES) is not present at this time, and supportive measures are given.

The goals for treatment of a fat embolism are as follows:

  • Maintenance of adequate oxygenation and ventilation with use of airway pressure release ventilation (APRV)
  • Prophylaxis of deep venous thrombosis and stress-related gastrointestinal bleeding
  • Administration of blood products as clinically indicated
  • Hydration
  • Maintenance of hemodynamic stability
  • Nutrition
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