Fat embolism syndrome: State-of-the-art review focused on pulmonary imaging findings

Abstract Background Fat embolism syndrome (FES) is a rare but potentially fatal complication of trauma or orthopedic surgery, which presents predominantly with pulmonary symptoms. Modern intensive care has improved the mortality rates, however diagnosis remains difficult, relying predominantly on a...

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Bibliographic Details
Published in:Respiratory medicine 2016-04, Vol.113, p.93-100
Main Authors: Newbigin, Katrina, Souza, Carolina A, Torres, Carlos, Marchiori, Edson, Gupta, Ashish, Inacio, Joao, Armstrong, Mitchel, Peña, Elena
Format: Article
Language:English
Subjects:
Bone surgery
Conflicts of interest
Consciousness
Diagnostic tests
Edema
Embolism, Fat - diagnostic imaging
Embolism, Fat - pathology
Embolisms
Fat embolism
High resolution computed tomography
Humans
Hypoxia
Laboratories
Medical imaging
Mortality
Multiple Pulmonary Nodules - diagnostic imaging
Multiple Pulmonary Nodules - pathology
Non thrombotic pulmonary embolism
Orthopedics
Postoperative period
Pulmonary arteries
Pulmonary imaging
Pulmonary/Respiratory
Respiratory distress syndrome
Tomography, X-Ray Computed - methods
Trauma
Urine
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Summary:Abstract Background Fat embolism syndrome (FES) is a rare but potentially fatal complication of trauma or orthopedic surgery, which presents predominantly with pulmonary symptoms. Modern intensive care has improved the mortality rates, however diagnosis remains difficult, relying predominantly on a combination of a classic triad of symptoms and non-specific, but characteristic radiological features. The aim of this review is to describe the main clinical and imaging aspects of FES, ranging from pathophysiology to treatment with emphasis on pulmonary involvement. Methods We reviewed the currently published literature on the main characteristics of FES. Results In a hypoxic patient with recent trauma or orthopedic surgery, the presence of diffuse, well-demarcated ground glass opacities or ill-defined centrilobular nodules on computed tomography (CT) of the chest are suggestive of FES. Conclusions Combination of the classic clinical syndrome in the appropriate clinical setting, together with the characteristic imaging findings on chest CT, can help to achieve the correct diagnosis. Management remains predominantly supportive care, and the benefit of medical therapies such as corticosteroids and heparin remains unclear.
ISSN:0954-6111
1532-3064
DOI:10.1016/j.rmed.2016.01.018