BACKGROUND: Patients undergoing cemented hip hemiarthroplasty may develop bone cement implantation syndrome (BCIS) which is a leading cause of intraoperative complications. The purpose of this study was to evaluate cardiovascular changes during cemented hip hemiarthroplasty in elderly patients. METHODS: Cemented hip hemiarthroplasty was performed on 72 patients with femoral neck fracture. All patients were catheterized with a radial artery catheter to assess mean arterial pressure (MAP) and arterial blood gas (ABG) in these time points: just before cementation, just after cementation (0th), 5 min (5th) and 10 min (10th) after cementation, and at the end of surgery (END). Also, systolic and diastolic blood pressure (SBP & DBP), heart rate and any arrhythmia or cardiac arrest was evaluated. RESULTS: Seventy-two patients (33 females, 39 males; mean age: 66.8±7 years) were evaluated. All parameters changed during cementation with a significant drop in MAP, SBP, and DBP immediately after cementation and pH and base excess decreased significantly (P<0.001) with no changes in O2 saturation. Mean heart rate rose until the 5th and then decreased dramatically with no bradycardia presentation. During cementation, 12 patients showed arrhythmia, but no cardiac-arrest was observed. CONCLUSIONS: Under strict observation of a anesthesiology care team, hemiarthroplasty can be a safe method for femoral neck fracture in elderly osteoporotic patients without severe cardiopulmonary compromise.
BACKGROUND:Patients undergoing cemented hip hemiarthroplasty may develop bone cement implantation syndrome (BCIS) which is a leading cause of intraoperative complications. The purpose of this study was to evaluate cardiovascular changes during cemented hip hemiarthroplasty in elderly patients. METHODS:Cemented hip hemiarthroplasty was performed on 72 patients with femoral neck fracture. All patients were catheterized with a radial artery catheter to assess mean arterial pressure (MAP) and arterial blood gas (ABG) in these time points: just before cementation, just after cementation (0th), 5 min (5th) and 10 min (10th) after cementation, and at the end of surgery (END). Also, systolic and diastolic blood pressure (SBP & DBP), heart rate and any arrhythmia or cardiac arrest was evaluated. RESULTS: Seventy-two patients (33 females, 39 males; mean age: 66.8±7 years) were evaluated. All parameters changed during cementation with a significant drop in MAP, SBP, and DBP immediately after cementation and pH and base excess decreased significantly (P<0.001) with no changes in O2 saturation. Mean heart rate rose until the 5th and then decreased dramatically with no bradycardia presentation. During cementation, 12 patients showed arrhythmia, but no cardiac-arrest was observed. CONCLUSIONS: Under strict observation of a anesthesiology care team, hemiarthroplasty can be a safe method for femoral neck fracture in elderly osteoporoticpatients without severe cardiopulmonary compromise.
Entities:
Keywords:
ABG; Bone cement; Hemiarthroplasty; Hemodynamics; Mean arterial pressure
Authors: Mohit Bhandari; P J Devereaux; Paul Tornetta; Marc F Swiontkowski; Daniel J Berry; George Haidukewych; Emil H Schemitsch; Beate P Hanson; Kenneth Koval; Douglas Dirschl; Pamela Leece; Marius Keel; Brad Petrisor; Martin Heetveld; Gordon H Guyatt Journal: J Bone Joint Surg Am Date: 2005-09 Impact factor: 5.284
Authors: Mihail-Lazar Mioc; Radu Prejbeanu; Dinu Vermesan; Horia Haragus; Marius Niculescu; Daniel Laurentiu Pop; Andrei Dan Balanescu; Daniel Malita; Bogdan Deleanu Journal: BMC Musculoskelet Disord Date: 2018-07-11 Impact factor: 2.362