Postoperative hypoxemia due to fat embolism

• Main Authors: Tarun Bhalla, Amod Sawardekar, Kevin Klingele, Joseph D Tobias
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2011-01-01
• Series: Saudi Journal of Anaesthesia
• Subjects: Hypoxemia; fat embolism; postoperative hypoxemia
• Online Access: http://www.saudija.org/article.asp?issn=1658-354X;year=2011;volume=5;issue=3;spage=332;epage=334;aulast=Bhalla

Although the reported incidence of fat embolism syndrome (FES) is low (approximately 1%), it is likely that microscopic fat emboli are showered during manipulation of long bone fractures. Even though there continues to be debate regarding the etiology and proposed mechanism responsible for FES, significant systemic manifestations may occur. Treatment is generally symptomatic based on the clinical presentations. We report a 10-year-old girl who developed hypoxemia following treatment of a displaced Salter-Harris type II fracture of the distal tibia. The subsequent evaluation and hospital course pointed to fat embolism as the most likely etiology for the hypoxemia. We discuss the etiology for FES, review the proposed pathophysiological mechanisms responsible for its clinical manifestations, present currently accepted diagnostic criteria, and discuss its treatment.