Role of corticosteroid as a prophylactic measure in fat embolism syndrome: a literature review.

Despite a number of studies on steroid therapy as a prophylactic measure in fat embolism syndrome (FES), there is no universal agreement about its role in this critical situation. The present article attempts to search the available literature, and provides a more lucid picture to the readers on this issue. Seven articles (total 483 patients) were reviewed and analyzed. Total of 223 patients received steroid (methyl prednisolone sodium succinate), while the remaining 260 patients formed the control population. Among these subjects, 9 patients in steroid-receiving group and 60 patients in the control group developed FES (P < 0.05). The lack of uniformities in these studies, variable dose and single-center trial are the principal limitations and confuses the surgeons to have definite conclusion. Large-scale, more uniformly designed, multi-centered, randomized, prospective trials are needed to determine the correct situations and dosage in which steroids provide the maximum benefit (with the least possible risk).