FES (Fat embolism syndrome)

Incidence: highest 10-40 years, men > women3

Diagnosis: no standard diagnostic criteria exist

Classic triad:

  1. Hypoxemia (the most common initial signs of FES)
  2. Neurologic abnormalities (typically manifest after the respiratory changes)
  3. Petechiae in nondependent regions (conjunctiva, head, neck, anterior thorax, or axilla)

all of which occur after an asymptomatic latent period of 24-48 hours postinjury

Fulminant cases of FES may present with right ventricular dysfunction, biventricular failure, acute respiratory distress syndrome, shock, and death.

Current treatment:

  • supportive care of the respiratory failure and hypovolemia, along with frequent monitoring of neurologic status in ICU (standard)

Latent period: 11-72 ชม.

Pathophysiology: not fully understood (OKU)

  • Now: two main processes:
    1. mechanical obstruction
    2. biochemical injury
  1. clinical signs and symptoms of FES
  2. subclinical phenomenon of fat embolization (occurs frequently with long bone and pelvic fractures)

 

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