Fat embolism syndrome natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Natural History
The syndrome typically occurs 12-24 hrs after the inciting event. It can occur as early as 12 hrs and as late as 2 weeks. Patients are often dyspneic, tachypneic and hypoxic. 50% of patients with FES require mechanical ventilation and progression to adult respiratory distress syndrome (ARDS) may develop.
The majority of patients develop neurologic abnormalities, usually after the development of respiratory distress. The usualy demonstrate an acute confusional state that may progress to coma. In most cases, if the patient survives, the neurologic abnormalities are transient.
The petichial rash is the last finding to develop. It occurs in only 30-50% of patients with FES. It is most often found on the head, neck, anterior thorax, subconjunctiva and axilla. It usually resolves in 5-7 days.
Scotoma, fever, lipiduria, disseminated intravascular coagulation (DIC) and cardiogenic shock are seen.
References
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