Successful Resuscitation of Bone Cement Implantation Syndrome in a Patient with Pre-Existing Pulmonary Hypertension: A Case Report

• 作者: Kumaresh Venkatesan Yeo S. H. Lynn
• 来源期刊: 麻醉学期刊(英文)
• 学科: 医学
• 关键词: Pulmonary Hypertension Bone Cement Implantation Syndrome
• 年，卷（期）: 2020,（8）
• 页码范围: 293-297
• 页数: 5页
• 分类号: R54

摘要

<b><span>Background: </span></b><span>In patients with pre-existing pulmonary hypertension undergoing surgery, there is an inherent risk of decompensation and right ventricular failure. Cemented hemi-arthroplasty in patients with pre-existing pulmonary hypertension predisposes them even more to morbidity and mortality from bone cement implantation syndrome (BCIS) with worsening of pulmonary hypertension. This risk should be recognized and steps taken for in</span><span>creased awareness, risk counselling and minimization of adverse effects.</span><span> </span><b><span>Case: </span></b><span>We report a case of successful resuscitation of a patient with pre-existing</span><span> pulmonary hypertension who developed 2 episodes of cardiac arrests—Grade 3 BCIS, shortly after cement implantation.</span><span> </span><b><span>Learning Points: </span></b><span>Patients with pre-existing pulmonary hypertension for cemented hemi-arthroplasty are at additional risks and should be identified.</span><span> </span><span>Adequate risk counselling needs to be undertaken prior to surgery.</span><span> </span><span>A multi-disciplinary team effort is required. Discussion should be undertaken with the orthopaedic surgeon about the risks and benefits of using cemented implants.</span><span> </span><span>The anaesthetist needs to be vigilant for signs of BCIS, especially at the time of cement implantation and </span><span>institute immediate resuscitation.</span><span> </span><span>Supportive treatment is the mainstay of </span><span>management.