Supportive care of right ventricular failure due to fat embolism syndrome

Kevin T Schwalbach; R Chad Wade; Takudzwa Mkorombindo; Sam K McElwee; J Michael Wells; Keith M Wille

doi:10.1016/j.rmcr.2021.101499

Supportive care of right ventricular failure due to fat embolism syndrome

Respir Med Case Rep. 2021 Aug 25:34:101499. doi: 10.1016/j.rmcr.2021.101499. eCollection 2021.

Authors

Kevin T Schwalbach¹, R Chad Wade^{2

3}, Takudzwa Mkorombindo^{2

3}, Sam K McElwee⁴, J Michael Wells^{2

3

5}, Keith M Wille²

Affiliations

¹ University of Alabama at Birmingham Department of Medicine, Birmingham, AL, USA.
² University of Alabama at Birmingham Division of Pulmonary, Allergy and Critical Care Medicine, Birmingham, AL, USA.
³ UAB Lung Health Center, Birmingham, AL, USA.
⁴ University of Alabama at Birmingham Division of Cardiovascular Disease, Birmingham, AL, USA.
⁵ Birmingham VA Medical Center, Birmingham, AL, USA.

Abstract

Pulmonary fat embolism is a common phenomenon in cases of traumatic long bone fractures, with only a minority developing the more catastrophic Fat Embolism Syndrome (FES). Diagnosis is clinical and requires a high index of suspicion. Treatment remains under-investigated, with common interventions having low quality level-of-evidence and no mortality benefit. In severe cases, focus should be on supporting the failing right ventricle through use of inotropes, pulmonary vasodilators, and mechanical circulatory support. This requires a thorough understanding of the unique physiology through the pulmonary circulation.

Keywords: Fat embolism; Hypoxemia; Pulmonary hypertension; Right ventricle.

Publication types

Case Reports

Grants and funding

T32 HL105346/HL/NHLBI NIH HHS/United States