title: Bone cement implantation syndrome: a report of four cases.
abstract: Cardiovascular collapse following use of methylmethacrylate for lower limb surgeries has been reported. However there are no reports of cement reaction following shoulder arthroplasty. We report series of four patients exhibiting cement reaction. Two of our patients had cardiovascular collapse following cement insertion during hip arthroplasty. Severe hemodynamic derangement and transient hypoxemia was observed during cemented arthroplasty of shoulder and knee respectively. Peripheral vasodilatory effects of the cement monomer, fat and marrow embolism and activation of the clotting cascade in the lungs, all contribute to cement reaction. Early and aggressive resuscitation with use of vasopressors, establishment of invasive hemodynamic monitoring and surgical modifications are the key to prevention of catastrophic outcome.
authors.affiliation: Consultant, Department of Anaesthesiology and Pain Management, Max Super specialty Hospital, Saket, New Delhi. 110017, India.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Govil
authors.forename: P N
authors.initials: PN
authors.lastname: Kakar
authors.forename: Deep
authors.initials: D
authors.lastname: Arora
authors.forename: Shibani
authors.initials: S
authors.lastname: Das
authors.forename: Nishkarsh
authors.initials: N
authors.lastname: Gupta
authors.forename: Deepak
authors.initials: D
authors.lastname: Govil
authors.forename: Sachin
authors.initials: S
authors.lastname: Gupta
authors.forename: Ashima
authors.initials: A
authors.lastname: Malohtra