| Intraoperative cerebral arterial embolization during total hip arthroplasty. | |
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MedLine Citation:
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PMID: 10910475 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Fat embolism to the pulmonary circulation is known to occur during total hip arthroplasty, especially during insertion of a cemented femoral component. Fat and air bubbles may enter the systemic circulation via a patent foramen ovale or through pulmonary circulation. METHODS: To determine whether microemboli to the brain were occurring during total hip arthroplasty, 23 patients underwent transcranial Doppler assessment of emboli to the middle cerebral artery during total hip arthroplasty. Surgery was performed with the patient in the lateral decubitus position so that the probe recorded from the nondependent side. RESULTS: Successful recordings were made in 20 patients, in 8 of 20 patients there were embolic signals, which ranging from 1 to 200. In all eight patients, signals were recorded during impaction of a cemented component or after relocation of the hip. Only one patient showed evidence of emboli with impaction of the acetabulum component. In two patients there were 150 and 200 embolic signals: in both mild respiratory symptoms developed. One patient became overtly agitated during a flurry of emboli. CONCLUSION: Cerebral microemboli can occur during total hip arthroplasty. Whether this contributes to changes in postoperative cognitive function is unknown. |
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Authors:
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C R Edmonds; D Barbut; D Hager; N E Sharrock |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Anesthesiology Volume: 93 ISSN: 0003-3022 ISO Abbreviation: Anesthesiology Publication Date: 2000 Aug |
Date Detail:
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Created Date: 2000-09-06 Completed Date: 2000-09-06 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 315-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, The Hospital for Special Surgery, New York, NY 10021, USA. EdmondsC@hss.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Arthroplasty, Replacement, Hip* Cognition Disorders / etiology Comorbidity Embolism, Fat / complications, ultrasonography* Female Humans Intraoperative Complications* Male Middle Aged Middle Cerebral Artery / ultrasonography* Prospective Studies Ultrasonography, Doppler, Transcranial |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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