Embolia grasa: un síndrome clínico complejo

fat embolism (fe) describes the presence of fat globules in the circulation. it may be associated with a clinical syndrome (fes) that can be readily identified by its signs and symptoms. it may follow traumatic events such as orthopedic or cosmetic surgery, or non-traumatic events. diverse theories try to explain the origin of fe and the fes, such as intravasation, upase and free fatty acids, fe of non-traumatic origin, and one of shock and coagulation. the clinical manifestations vary from mild to severe and include the respiratory, central nervous, dermatologic and hematologic systems. diagnosis may be established following gurd and/or lindeque's clinical criteria. fat determination in blood and urine lacks sensitivity; bronchoalveolar lavage to determine the presence of fat depends on an adequate sample of alveolar macrophages. high resolution thoracic tomography and nuclear magnetic resonance of the brain can be helpful. treatment is only palliative and non-specific. in most studies, steroids have decreased mortality, but if ventilatory support is needed, the mortality rate increases. prevention is possible during orthopedic and trauma surgery; hypoxemia, hypotension, and perioperative and post-traumatic dehydration should be avoided.