Fat embolism management may consist of a combination of supportive care and medications, as well as orthopedic surgery to help address related bone fractures.

Fat embolism refers to a collection of fat emboli, which can gather in the bloodstream and cause a blockage.

Also called fat embolism syndrome (FES), this condition is commonly caused by a bone fracture, and in some cases, after liposuction and related cosmetic procedures.

A fat embolism is considered serious and potentially life threatening within a few hours of happening because it can cut off blood flow to your lungs, heart, or brain. Immediate treatment and management are critical if a doctor suspects you have FES.

A doctor may recommend a combination of management techniques depending on the location of the fat embolism, its cause, and your symptoms.

Key Terms: Emboli and embolism

A fat embolus (emboli, if there’s more than one) is a tiny droplet of fat, usually from bone marrow after a broken bone, that breaks loose and travels in the bloodstream.

Fat embolism is a medical condition that occurs when enough fat emboli get stuck in blood vessels and start causing symptoms.

In plain terms, it’s like little bits of fat (emboli) breaking loose and floating in your blood, then getting stuck and clogging blood flow to important organs (embolism).

Treatment for fat embolism syndrome focuses mainly on supportive measures like providing oxygen therapy and stabilizing the person.

New medications are being studied to help treat fat embolism. To date, however, corticosteroids are the most common line of therapy, but typically used only in severe cases.

Corticosteroids suppress the immune system, thereby decreasing inflammation caused by acute infections and chronic illnesses. They may also increase the risk of infection (since the immune system is inhibited), which is a serious concern in people with critical conditions.

Due to the multiple conditions they help treat, corticosteroids are considered one of the most commonly prescribed drugs worldwide.

These medications may help prevent changes in fat emboli, such as an increase in size. They may also help prevent white blood cells from clustering together in the bloodstream.

However, steroid medications are used cautiously due to the increased risk of osteoporosis when taken long term. Having osteoporosis may increase your chance of bone fractures and subsequent FES.

Although rare, corticosteroids are non-traumatic risk factors for FES development. Before prescribing corticosteroids for fat embolism, a doctor will carefully weigh the benefits versus risks for your unique case.

Complications

The main complications of an untreated fat embolism may include:

  • Respiratory failure: Fat emboli may block blood vessels in the lungs, leading to low oxygen and shortness of breath.
  • Brain damage: Due to low oxygen supply, an untreated fat embolism can lead to long-term confusion and cognitive issues. In severe cases, coma.
  • Multiple organ damage: When blood flow is cut off, the kidneys, heart, and eyes can be damaged.
  • Shock: The body can collapse into dangerously low blood pressure and poor circulation due to an untreated fat embolism.
  • Death: In the most severe scenario, untreated cases of fat embolism can be fatal.

These are serious outcomes that happen if fat embolism is not treated promptly, not just warning signs.

Supportive care is considered the primary approach to managing fat embolism. Its overall goal is to provide oxygen to vital organs that may not be receiving enough due to FES.

If you have FES, you will be admitted to an ICU setting. You will likely receive supportive care here. A doctor may recommend supplemental oxygen and ask you to stay still as much as possible to prevent the dislodgement of any further fat emboli.

Fat embolism in children

If your child has Duchenne muscular dystrophy, be sure to let the emergency care team know. They may need to use noninvasive mechanical ventilation techniques to prevent carbon dioxide levels from becoming too high and causing respiratory failure.

Intubation may be recommended for moderate to severe respiratory problems from FES that do not get better with noninvasive ventilation.

Doctors don’t usually consider surgery a main line of treatment for fat embolism. However, in some cases, orthopedic surgery may be used as a preventive measure that can reduce the risk of FES.

In particular, fixation devices used in the management of long bone fractures can help reduce the incidence of fat emboli released from broken bones into the bloodstream.

If a doctor recommends surgery for a bone fracture, they will take extra care to reduce pressure inside the bone marrow. This will also help reduce the risk of fat embolism.

Surgery to help stabilize bone fractures is currently the only preventive medical technique for FES.

While it may not be possible to prevent fat embolism entirely, reducing your risk of traumatic injuries can also help decrease bone fractures.

For example, always wear a seat belt while in a vehicle or a wheelchair, and use assistive devices when needed. You can also reduce tripping hazards around your home and workplace.

It’s also important to be on the lookout for possible symptoms of a fat embolism after any fall or other traumatic injury. This way, you will know when to seek prompt treatment.

On average, it takes between 24 and 72 hours for a fat embolism to develop after a traumatic injury.

When to seek emergency care

Seek emergency medical attention right away after an injury or bone fracture if you or a loved one experiences the following symptoms within an hour:

  • shortness of breath
  • confusion
  • seizures
  • severe headache
  • petechiae (purple little skin dots in a cluster)

Fat embolism is a collection of fat emboli that enter the bloodstream. It’s primarily caused by fat dislodgement from bone fractures.

Supportive care is considered the best way to help people recover from a fat embolism, and it may reduce life threatening complications such as cerebral edema (fluid swelling in the brain) or acute respiratory distress.

Seek emergency medical care if a loved one experiences any symptoms of respiratory difficulties or sudden neurological changes following a bone fracture. An emergency care team can provide oxygen support while also assessing the risk of fat embolism.