Fat Embolism Syndrome

[EricTAMUCC-BSN, BSN, RN]

I'm interested in fat embolisms that occur following an invasive procedure like ORIF or liposuction. Is there anything else that the nurse or physician can do besides provide good arterial oxygenation, restrict fluid intake, and administer meds? Are there any invasive procedures the physician can perform? I would hate feeling helpless in one of these situations.

[EricTAMUCC-BSN, BSN, RN]

anyone?

[nowplayingEDRN]

Hope this helps you out some. :)

Christie

Fat embolism syndrome.

Am J Orthop 2002 Sep;31(9):507-12 (ISSN: 1078-4519)

Parisi DM; Koval K; Egol K

Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, USA.

Fat embolization and the clinical syndrome associated with this pathology are poorly understood complications of skeletal trauma. Fat embolization is characterized by release of fat droplets into systemic circulation after a traumatic event. Fat embolism syndrome (FES) is an infrequent clinical consequence of fat embolization. Classically, FES presents with the triad of pulmonary distress, mental status changes, and petechial rash 24 to 48 hours after pelvic or long-bone fracture. FES incidence increases with the number of fractures sustained by an individual. Many clinicians believe that FES incidence has decreased over the past several decades secondary to advances in resuscitative measures. FES pathophysiology remains unclear. Current theories involve common mechanical and biochemical mechanisms that explain how fat emboli manifest as FES. Much controversy surrounds the question of whether there is a causal relation between intramedullary nailing and FES onset. Clinical diagnosis is essential, as laboratory and radiographic findings are nonspecific. Early supportive pulmonary therapy and other resuscitative measures may halt the pathophysiologic cascade and prevent clinical deterioration. Fortunately, if FES is diagnosed early, and pulmonary and cardiac functions are optimally supported, prognosis is very good.

[gwenith, BSN, RN]

I would have to do a literature search as the research into this area is keeping ahead of us poor Idjuts but Fat Embolisation syndrom last I looked was one of those where it is more a pulmonary reaction than a clogged vessel. It is not like a thromboembolism where a fat clot breaks away from a vein in the leg and floats through the right heart into the pulmonary circulation then sticks like a cork in a hose. This is more like tiny shot gun pellets of fat, maybe even individual cells or parts of cells (they are still unsure) that set up the pulmonary reaction we see.

[nowplayingEDRN]

You have it down to a science almost Gwenith, dear! :) That was putting is plain and simple.

[helix]

So, do they always have the petechial rash? And if so, why?

Helix

[nowplayingEDRN]

Helix...

Ta answer your question please see the following link. It was too much info to copy and paste. Hope it helps.

http://www.orthoteers.co.uk/Nrujp~ij33lm/Orthfatembolism.htm

[helix]

Thank you UntamedSpirit. That was helpful.

Helix

[nowplayingEDRN]

Happy to help out Helix! Glad it was of benefit to you. :)