[3][1] Other potential causes include pancreatitis, orthopedic surgery, bone marrow transplant, and liposuction.
[1] The symptoms of fat embolism syndrome (FES) can start from 12 hours to 3 days after diagnosis of the underlying clinical disease.
[7] However, fat globules have been detected in 67% of those with orthopaedic trauma and can reach as high as 95% if the blood is sampled near the fracture site.
As the early operative fixation of long bone fractures became a common practice, the incidence of FES has been reduced to between 0.9% and 11%.
[6] There are three major diagnostic criteria proposed for fat embolism syndrome, however, none of them are validated and accepted universally.
However, movement of the fracture ends of the long bones during the operative fixation can cause transient increase of fat emboli in the blood circulation.
Other methods such as drilling of holes in the bony cortex, lavaging bone marrow prior to fixation, and the use of tourniquets to prevent embolisation have not been shown to reduce the rates of FES.
Corticosteroid can be used to limit free fatty acid levels, stabilising membranes, and inhibit leukocyte aggregation.
However, a randomised trial conducted in 2004 reported no differences in FES incidence when comparing treatment with the control group.
[5] Heparin has been used in the prevention of venous thrombosis in post-operative patients; however its regular use in those with FES has been contraindicated due to increase risk of bleeding in those with polytrauma.
[5] Placement of inferior vena cava filters has been proposed to reduce the amount of emboli going into the lung vascular system, however, this method has not been studied in detail.
[6] Once FES develops, the person should be admitted into intensive care unit (ICU), preferably with central venous pressure (CVP) monitoring.
Frequent Glasgow coma scale (GCS) charting is required to assess the neurological progression of a person with FES.
[6] In 1861, Zenker first reported on the autopsy findings of fat droplets found in the lungs of a railway worker who died due to severe thoraco-abdominal crush injury.
In 2015, Singaporean couple Pua Hak Chuan and Tan Hui Zhen were charged with the abuse and murder of Annie Ee Yu Lian, who died due to multiple physical abuses which lasted for eight months before her death.