Global tests on coagulation and fibrinolysis in systemic and pulmonary circulation accompanying hip arthroplasty with acrylic cement.
Sudden cardio-respiratory collapse (CRC) within seconds after implantation of methylmethacrylate cement and femoral prosthesis during hip replacement surgery, accounted at our hospital among 315 patients for a mortality of 0.6%. This prompted our pathophysiological studies concentrating on the critical intraoperative period for this complication. This series of 6 patients with osteoarthrosis was followed with established parameters on coagulation and fibrinolysis in arterial and mixed venous blood withdrawn frequently during and after total hip arthroplasty. The surgical procedure induced activation in both systems as evidenced by a gradual and statistically significant drop in level of blood platelets, fibrinogen, vitamin K dependent clotting factors. At the end of operation soluble fibrin and moderately elevated concentrations of FDP/FRA were demonstrated. The results were similar in corresponding arterial and mixed venous blood specimens. The perioperative changes were not potentiated by the introduction of cement and the implantation of the prosthetic components. The postoperative changes had the same pattern and the same magnitude as those following other types of major surgery. The present results do not indicate marked alterations in coagulation and/or fibrinolysis in the critical period for CRC to develop.
Dahl
O E
OE
Department of Surgery, Diakonhjemmets sykehus (The Norwegian Lutheran Hospital), Oslo.
Molnar
I
I
Rø
J S
JS
Vinje
A
A
D001777:Blood Coagulation; D005260:Female; D005342:Fibrinolysis; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008768:Methylmethacrylates; D011652:Pulmonary Circulation
D008768:Methylmethacrylates