Fat Embolism in Polytrauma Patients

Abstract

FES most commonly occurs in orthopedic trauma patients, especially in long bones and pelvis fractures, with an incidence proportional to the number of bones involved. In recent years the numerous simultaneous improvements in the management of trauma patients have resulted in a marked fall in its incidence. A controversy regarding its pathogenesis still exists. Despite the technological advances in diagnostic imaging and numerous attempts to find a confirmatory laboratory test, there is no specific diagnostic tests that can point out to FES. Therefore, the diagnosis of FES depends largely on clinical features and ruling out other differential diagnoses. To aid in the diagnosis of FES various scoring systems have been proposed, which remained essentially unchanged over the past 30 years. An early diagnosis can be achieved with a high degree of suspicion, combined with continuous monitoring of vitals including close monitoring of pulse oximetry and ABG analysis in high risk patients. Treatment is mainly supportive. Early Initiation of prompt supportive management will help in reducing the morbidity and mortality among such patients. Early fracture fixation and modern critical care should help minimize the impact of fat embolism.