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Fat embolism syndrome

Gerald L Weinhouse, MD
Section Editor
Polly E Parsons, MD
Deputy Editor
Geraldine Finlay, MD


Fat embolism syndrome (FES) is a rare syndrome that, when severe, is associated with respiratory failure, neurocognitive deficit, and death. It remains a diagnostic challenge for clinicians, but prompt recognition is important so that supportive therapy can be instituted early.

The pathogenesis and etiology, clinical presentation and diagnosis, prevention, treatment, and outcomes of FES are reviewed here. Other embolism syndromes are discussed separately. (See "Overview of acute pulmonary embolism in adults" and "Amniotic fluid embolism syndrome" and "Pulmonary tumor embolism and lymphangitic carcinomatosis in adults: Diagnostic evaluation and management" and "Air embolism".)


Fat embolism is defined by the presence of fat globules in the pulmonary circulation. The term fat embolism syndrome (FES) refers to the clinical syndrome that follows an identifiable insult which releases fat into the circulation, resulting in pulmonary and systemic symptoms. (See 'Epidemiology and etiology' below and 'Clinical presentation' below and 'Diagnosis' below.)


Fat embolism syndrome (FES) is a rare clinical syndrome that can complicate a wide variety of clinical conditions (table 1), particularly those where fat is manipulated. Almost all cases of FES are due to long bone and pelvic fractures (bone marrow contains a high content of fat). However, some cases are associated with trauma in the absence of orthopedic fractures and rare cases are nontrauma-related.

Orthopedic fractures or trauma — Rates of FES in orthopedic trauma patients varies from <1 percent to >30 percent, the wide range likely reflecting study population heterogeneity and a lack of standardization for diagnostic criteria [1,2].

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Literature review current through: Nov 2017. | This topic last updated: Sep 21, 2017.
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