Efficacy of Corticosteroids in Prevention of Fat Embolism Syndrome in Patients with Long Bone Fracture

Fat embol ism syndrome refers to a constellation of symptomssecondary to the presence of fat globules in the lung parenchymaand/or peripheral blood circulation. the syndrome ismost often seen in association with long bone or pelvic fracturesand can cause significant morbidity and mortality. thepresent randomized double blind placebo-controlled trial wasconducted to evaluate the efficacy of prophylactic corticosteroidsin the prevention of fat embolism syndrome and arterialhypoxia in patients with long bone fractures. ninety-one patientswith long bone fractures were randomized to case andcontrol groups; 38 and 53 individuals, respectively . the patientsin the case group received a single dose of 10 mg/kgintravenous methylprednisolone succinate upon presentationto the emergency room. the control group received placebo(normal saline). the primary endpoints evaluated were tire'presence of fat embolism syndrome, based on the gurd criteria.total two patients with fat embolism syndrome were observedin the corticosteroid-treated group (5/2%) comparedwith five patients in the control (9.4%; p=0.4). arterial hypoxemiawas observed in one patient in the corticosteroidtreatedgroup (2/6%) versus eight patients in the control group(17/0%; p= 0.07). mean arterial oxygen was not significantlydifferent between the two groups (p=0.07). it seems thatsingle dose methylprednisolone succinate (10 mg/kg intravenously)is not effective as prophylaxis for fat embolism syndromeand arterial hypoxemia.