Document Detail


Cardiac output during hemiarthroplasty of the hip. A prospective, controlled trial of cemented and uncemented prostheses.
MedLine Citation:
PMID:  11341430     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In a prospective, controlled study, we measured the effect on cardiac output of the introduction of methylmethacrylate during hemiarthroplasty for displaced fractures of the femoral neck. We treated 20 elderly patients who were similar in age, height, weight and preoperative left ventricular function with either cemented or uncemented hemiarthroplasty. Using a transoesophageal Doppler probe, we measured cardiac output before incision and at six stages of the procedure: during the surgical approach, reaming and lavage of the femoral canal, the introduction of cement, the insertion of the prosthesis, and in reduction and closure. We found that before the cement was introduced, there was no difference in stroke volume or cardiac output (p > 0.25). Cementation produced a transient but significant reduction in cardiac output of 33% (p < 0.01) and a reduction in stroke volume of 44% (p < 0.02). The introduction of cement did not affect the heart rate or mean arterial pressure. There was no significant difference in cardiac function on insertion of the prosthesis. Standard non-invasive haemodynamic monitoring did not detect the cardiovascular changes which may account for the sudden deaths that sometimes occur during cemented hemiarthroplasty. The fall in stroke volume and cardiac output may be caused by embolism occurring during cementation, but there was no similar fall during reaming or insertion of the prosthesis.
Authors:
D I Clark; A B Ahmed; B R Baxendale; C G Moran
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of bone and joint surgery. British volume     Volume:  83     ISSN:  0301-620X     ISO Abbreviation:  J Bone Joint Surg Br     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-05-08     Completed Date:  2001-05-31     Revised Date:  2010-11-10    
Medline Journal Info:
Nlm Unique ID:  0375355     Medline TA:  J Bone Joint Surg Br     Country:  England    
Other Details:
Languages:  eng     Pagination:  414-8     Citation Subset:  AIM; IM    
Affiliation:
Queen's Medical Centre, Nottingham, England.
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MeSH Terms
Descriptor/Qualifier:
Aged
Arthroplasty, Replacement, Hip / adverse effects*
Bone Cements / adverse effects*
Cardiac Output / physiology*
Echocardiography, Transesophageal
Femoral Neck Fractures / surgery
Hip Prosthesis*
Humans
Methylmethacrylate
Middle Aged
Prospective Studies
Prosthesis Design
Stroke Volume / physiology
Chemical
Reg. No./Substance:
0/Bone Cements; 80-62-6/Methylmethacrylate
Comments/Corrections
Comment In:
J Bone Joint Surg Br. 2003 Jan;85(1):149; author reply 149   [PMID:  12585595 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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