Hemodynamic and Arterial Blood Gas Parameters during Cemented Hip Hemiarthroplasty in Elderly Patients.
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.
Mehran Soleimanha MD, Ahmad Reza Mirbolook MD, Mohsen Mardani-Kivi MD, Department of Orthopedics, Guilan University of Medical Science, Rasht, Iran.
Mehran
M
Soleimanha
Mehran Soleimanha MD, Ahmad Reza Mirbolook MD, Mohsen Mardani-Kivi MD, Department of Orthopedics, Guilan University of Medical Science, Rasht, Iran.
Abbas
A
Sedighinejad
Mehran Soleimanha MD, Ahmad Reza Mirbolook MD, Mohsen Mardani-Kivi MD, Department of Orthopedics, Guilan University of Medical Science, Rasht, Iran.
Mohammad
M
Haghighi
Mehran Soleimanha MD, Ahmad Reza Mirbolook MD, Mohsen Mardani-Kivi MD, Department of Orthopedics, Guilan University of Medical Science, Rasht, Iran.
Bahram Naderi
BN
Nabi
Mehran Soleimanha MD, Ahmad Reza Mirbolook MD, Mohsen Mardani-Kivi MD, Department of Orthopedics, Guilan University of Medical Science, Rasht, Iran.
Ahmad Reza
AR
Mirbolook
Mehran Soleimanha MD, Ahmad Reza Mirbolook MD, Mohsen Mardani-Kivi MD, Department of Orthopedics, Guilan University of Medical Science, Rasht, Iran.
Mohsen
M
Mardani-Kivi
ABG; Bone cement; Hemiarthroplasty; Hemodynamics; Mean arterial pressure