Fat embolism syndrome following severe blunt chest trauma treated with veno-venous extracorporeal membrane oxygenation: A case report.

Background: Fat embolism syndrome (FES) often occurs following long bone fractures and presents with respiratory symptoms in 90 % of cases. Although rare, the mortality rate ranges from 5 % to 20 %. Its pathophysiology involves fat obstruction in the pulmonary arteries or free fatty acids that damage the alveoli. Treatment primarily involves supportive care, including lung-protective ventilation strategies such as acute respiratory distress syndrome (ARDS) management. We report a case of severe FES that required veno-venous extracorporeal membrane oxygenation (VV-ECMO). Case presentation: A man in his 30s sustained multiple traumatic injuries, including bilateral pneumothorax, unstable pelvic fractures, and multiple rib and limb fractures, after falling from the seventh floor of a building. The Injury Severity Score and probability of survival were 43 and 10.4 %, respectively. The initial management included chest drainage, external pelvic fixation, and massive transfusion. On day 9, the patient developed ARDS (PaO Conclusion: VV-ECMO can be life-saving for FES with ARDS, especially when standard treatments are not feasible owing to injury constraints. Early implementation is recommended in select cases to improve outcomes.