Hip Pelvis.  2014 Dec;26(4):243-249. 10.5371/hp.2014.26.4.243.

Effect of Pressurized Cement Insertion on Cardiopulmonary Parameters during Cemented Hip Hemiarthroplasty: A Randomized Prospective Study

• Song WS
• Choi JC
• Kim TH
• Oh SH
• Park SR
• Park BH

• KMID: 1907700
• DOI: http://doi.org/10.5371/hp.2014.26.4.243

Abstract

PURPOSE
We aimed to investigate the cardiopulmonary effects of pressurized cement insertion in elderly patients undergoing cemented hip hemiarthroplasty.
MATERIALS AND METHODS
We conducted a randomized prospective study on elderly patients undergoing cemented hip hemiarthroplasty. Patients were divided into pressurized and non-pressurized groups based on the pressure application during cement insertion. We measured mean arterial blood pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), arterial blood gases and serotonin concentration in blood. These variables were measured before bone cement insertion, and 3 and 5 minute after insertion. They were also measured immediately and 15 minutes after reduction.
RESULTS
In cemented hip hemiarthroplasty, there were no significant change in MAP (P=0.92), SBP (P=0.85), DBP (P=0.98), HR (P=0.97) and serotonin concentration over time. There were no statistically significant difference between the two groups in MAP, SBP, DBP, HR, PO2, PaCO2, SaO2 and serotonin concentration, though three minutes after cement insertion, both groups showed decreases in SBP, DBP and MBP.
CONCLUSION
The pressurization method in cemented hip hemiarthroplasty was not found to be related with development of bone cement syndromes in elderly patients.

Keyword

Bone cement syndrome; Hip arthroplasty; Pressurization; Elderly patients

MeSH Terms

Aged
Arterial Pressure
Blood Pressure
Gases
Heart Rate
Hemiarthroplasty*
Hip*
Humans
Prospective Studies*
Serotonin
Gases
Serotonin

Figure

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  Fig. 1 Pulmonary vessel with the embolus comprising fat, platelets, fibrin and marrow debris. ① Reflex vasoconstriction and endothelial production of endothelin 1 (ET-1). ② Release of vasoconstriction mediators; platelet derived growth factor (PDGF), serotonin (5-HT), thromboxane A2 (Tx-A2), platelet activating factor (PAF) and adenosine diphosphate (ADP). ③ Vasoconstriction attributable to non-cellular components of the embolus including thrombin.

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  Fig. 2 Changes in the mean systolic blood pressure (SBP) over time in the two groups (P=0.85).

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  Fig. 3 Changes in the mean diastolic blood pressure (DBP) over time in the two groups (P=0.98).

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  Fig. 4 Changes in the mean mean blood pressure (MBP) over time in the two groups (P=0.92).

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  Fig. 5 Changes in the mean heart rate (HR) over time in the two groups (P=0.97).

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