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General Practice 2023

Fat embolism: what é, causes, symptoms and treatment

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Fat embolism: what é, causes, symptoms and treatment
Fat embolism: what é, causes, symptoms and treatment

Fat embolism happens when some blood vessels are obstructed by fat droplets, which usually happens after fractures of long bones, such as the bones of the legs, thighs or hips, but which can also arise after surgery orthopedic or aesthetic procedures, such as liposuction, for example.

Fat droplets can spread through the body's veins and arteries, being carried by the bloodstream and reaching various places and organs of the body. Usually, embolism only causes serious damage when it happens in large numbers or when the affected organs are:

  • Lungs: these are the main organs affected, which can cause shortness of breath and low blood oxygenation. Understand more about how it happens and other causes of pulmonary embolism;
  • Brain: causes typical stroke changes, such as loss of strength, changes in walking, vision changes and speech difficulties, for example;
  • Skin: inflammation occurs that causes reddened lesions and a tendency to bleed.

However, other organs such as kidneys, retina, spleen or liver, for example, can also be affected and have their function compromised.

Main causes

Fat embolism can be caused by situations such as:

  • Bone fracture, such as the femur, tibia and pelvis, after a car accident or fall;
  • Orthopedic surgery, such as knee or hip arthroplasty;
  • Plastic surgery, such as liposuction or filling with fat.

Fat embolism can also happen without a clear reason, spontaneously, which is more rare.Some of the people most at risk are people with generalized infections, people with sickle cell anemia crisis, pancreatitis, diabetes, hepatic steatosis, those on prolonged use of corticosteroids or with extensive burns.

Possible symptoms

Usually, fat embolism affects small vessels in the circulation, so it does not always cause symptoms, except when a massive embolism occurs, that is, when it reaches many blood vessels to the point of compromising circulation and organ functioning. Some of the symptoms that may arise include shortness of breath, headache, changes in vision or speech, weakness, drowsiness, loss of consciousness and coma, as well as skin lesions.

The diagnosis of embolism is made by the physician's clinical evaluation, and some tests can help to demonstrate areas of organ damage due to lack of blood flow, such as MRI.

When Fat Embolism Syndrome Occurs

Fat embolism can be called fat embolism syndrome when it is severe and affects the lungs, brain, blood clotting and skin at the same time, causing a very serious condition that includes difficulty breathing, brain and reddened skin lesions.

Only about 1% of cases of fat embolism develop this syndrome, which is so serious because, in addition to the obstruction of the vessels by fat droplets, it also triggers chemical reactions in the circulation that produce an intense inflammatory reaction in the body.

How the treatment is done

Although there is no specific treatment to cure fat embolism, there are measures used by the doctor capable of controlling symptoms and facilitating recovery. In some cases, this monitoring can be done in an ICU environment, until there is improvement and stabilization of the clinical picture.

Some options used by the physician include the use of a catheter or oxygen mask, in addition to continuous monitoring of vital signs. If necessary, hydration can be performed in the vein with saline solution, as well as medications used to regulate blood pressure.

Furthermore, some doctors may try the use of corticosteroid medications in an attempt to reduce the inflammatory reaction of the disease.

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