Fat embolism syndrome medical therapy

Jump to: navigation, search

Fat embolism syndrome Microchapters


Patient Information


Historical Perspective




Differentiating Fat embolism syndrome from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


History and Symptoms

Physical Examination

Laboratory Findings


Chest X Ray



Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies


Medical Therapy


Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Fat embolism syndrome medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides


American Roentgen Ray Society Images of Fat embolism syndrome medical therapy

All Images
Echo & Ultrasound
CT Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Fat embolism syndrome medical therapy

CDC on Fat embolism syndrome medical therapy

Fat embolism syndrome medical therapy in the news

Blogs on Fat embolism syndrome medical therapy

Directions to Hospitals Treating Fat embolism syndrome

Risk calculators and risk factors for Fat embolism syndrome medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Feham Tariq, MD [2]


The mainstay of treatment of fat embolism syndrome is supportive care, anticoagulation in some cases and corticosteroid therapy in severe respiratory distress. The main steps followed in conservative management include in ICU supportive care, fluid resuscitation, supplemental oxygen, mechanical ventilation and intracranial monitoring.

Medical Therapy

The mainstay of treatment of fat embolism syndrome is supportive care, anticoagulation in some cases and corticosteroid therapy in severe respiratory distress. Following are the main steps followed for the management:[1][2]

Conservative management

The following conservative measures are taken to manage fat embolism syndrome:[3][4]

In ICU supportive care

Supplemental oxygen


The goals of anticoagulant therapy are as follows:


  • Increased risk of hemorrhage
  • Increased production of free fatty acids from fat break down



The rationale for administering steroids is based on the pro-inflammatory effect of fat embolism. They are used most commonly in the following patients:[6]

Those who have life-threatening complications of fat embolism syndrome such as:

Preferred regimen (1): Hydrocortisone 100 mg PO q8h daily for 5 days

Preferred regimen (2): Methylprednisone 1-1.5mg/kg/day for 5 days


Fluid resuscitation

The aims of fluid resuscitation are as follows:[7][8]

  • Maintaining intravascular volume
  • Binding of fatty acids released into the circulation
  • Decrease the lung injury

Albumin along with balanced electrolyte solution is recommended.

Mechanical ventilation:

Invasive or non-invasive mechanical ventilation is commonly used.

Mechanical cardiac support devices

  • Used in patients with refractory shock


  1. Lindeque BG, Schoeman HS, Dommisse GF, Boeyens MC, Vlok AL (1987). "Fat embolism and the fat embolism syndrome. A double-blind therapeutic study". J Bone Joint Surg Br. 69 (1): 128–31. PMID 3818718.
  2. Babalis GA, Yiannakopoulos CK, Karliaftis K, Antonogiannakis E (2004). "Prevention of posttraumatic hypoxaemia in isolated lower limb long bone fractures with a minimal prophylactic dose of corticosteroids". Injury. 35 (3): 309–17. PMID 15124801.
  3. Levy D (1990). "The fat embolism syndrome. A review". Clin Orthop Relat Res (261): 281–6. PMID 2245559.
  4. Cavallazzi R, Cavallazzi AC (2008). "[The effect of corticosteroids on the prevention of fat embolism syndrome after long bone fracture of the lower limbs: a systematic review and meta-analysis]". J Bras Pneumol. 34 (1): 34–41. PMID 18278374.
  5. Müller C, Rahn BA, Pfister U, Meinig RP (1994). "The incidence, pathogenesis, diagnosis, and treatment of fat embolism". Orthop Rev. 23 (2): 107–17. PMID 8196970.
  6. White T, Petrisor BA, Bhandari M (2006). "Prevention of fat embolism syndrome". Injury. 37 Suppl 4: S59–67. doi:10.1016/j.injury.2006.08.041. PMID 16990062.
  7. Shaikh N (2009). "Emergency management of fat embolism syndrome". J Emerg Trauma Shock. 2 (1): 29–33. doi:10.4103/0974-2700.44680. PMC 2700578. PMID 19561953.
  8. Habashi NM, Andrews PL, Scalea TM (2006). "Therapeutic aspects of fat embolism syndrome". Injury. 37 Suppl 4: S68–73. doi:10.1016/j.injury.2006.08.042. PMID 16990063.