Fat embolism syndrome

Question 1

what causes fat embolism syndrome?

Answer 1

fractures: long bone, pelvic and other marrow containing bones
orthopedic procedures
pancreatitis
sickle cell dx

Question 2

clinical presentation of fat embolism syndrome:

Answer 2

onset is within 24-72 hrs after injury or insult
classic triad: respiratory distress 95%) - hypoxia, dyspena, tachypnea, and acute lung injury needing mechanical ventilation
neurological symptoms (86%) of pts with altered mentation and seizures
Petechial rash (20-50%) of pts with head, neck, thorax, and axilla and subjunctiva

Question 3

prevention of fat embolism syndrome:

Answer 3

early immobilization of fractures, operative correction

supportive care

Question 4

Triad of fat embolism:

Answer 4

hypoxemia, neurological abnormalities and petechial rash

Question 5

when do fat embolism symptoms develop?

Answer 5

24-72 hrs after injury

Question 6

Neurological symptoms associated with fat embolism include:

Answer 6

confusion, seizures, focal deficits and appear after respiratory distress

Question 7

fat embolism rash are present in about

Answer 7

20-50% of pts and resolves in about 5-7 days

Question 8

what is seen on CXR or CT scan of chest with fat embolism?

Answer 8

see CXR with airspace dx due to edema or alveolar hemorrhage but are frequently normal.

See bilateral ground glass opacities with thickening normal.

V/Q scans show perfusion defects with normal ventilatory patterns

Question 9

how is bronchoscopy helpful for fat embolism syndrome?

Answer 9

it can help establish diagnosis by detecting lipid laden alveolar macrophages.

Question 10

Treatment of fat emoblism

Answer 10

supportive with adequate oxygenation, stable hemodynamics and prevention of DVT and GI and proper nutrition

most people recover without issue.