The role of shock in the pathogenesis of fat embolism after trauma

Experimental studies and pathological investigations indicate that intrusion of fat into the circulation is common after trauma. This may not have any effect unless frank hypovolaemia supervenes upon changes in the blood vessels, manifested by a deficient vasomotility in shock. After fat embolism disseminated intravascular coagulopathy may occur as a consequence of the haematological changes and disturbances of capillaries. The morphological appearance of massive post-traumatic fat embolism evolves from the compensatory effect of accumulated synergistic factors that primarily induced the changes. From this point of view fat embolism should be recognized in the additional important role of an epiphenomenon of post-traumatic shock.