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 ۷۲ 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 (۰th), ۵ min (۵th) and ۱۰ min (۱۰th ) 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 (۳۳ females, ۳۹ males; mean age: ۶۶.۸±۷ 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<۰.۰۰۱) with no changes in O۲ saturation. Mean heart rate rose until the ۵th and then decreased dramatically with no bradycardia presentation. During cementation, ۱۲ 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. 

Keywords:

ABG , Bone cement , Hemiarthroplasty , Hemodynamics , Mean arterial pressure