Pulmonary circulatory changes after bilateral total knee arthroplasty during regional anesthesia.
J Clin Anesth
; 25(1): 4-8, 2013 Feb.
Article
em En
| MEDLINE
| ID: mdl-23391339
ABSTRACT
STUDY OBJECTIVE:
To monitor the pulmonary hemodynamics of patients undergoing bilateral total knee arthroplasty (BTKA) intraoperatively and up to 24 hours following surgery.DESIGN:
Prospective observational study.SETTING:
University-affiliated teaching hospital. PATIENTS 30 ASA physical status 2 and 3 patients scheduled for single-stage, cemented BTKA during epidural anesthesia.INTERVENTIONS:
Pulmonary artery catheters were in all patients. MEASUREMENTS Systemic vascular resistance (SVR), pulmonary vascular resistance (PVR), the ratio of PVR to SVR at baseline, at the beginning of surgery, and after each knee implantation were recorded and compared with measurements taken one day postoperatively (POD 1). MAINRESULTS:
On POD 1, PVR/SVR was increased by 30% compared with baseline (P < 0.0001) and by 20% versus the end of surgery (P < 0.0001). Systemic vascular resistance decreased during surgery and was significantly lower than baseline at 24 hours after surgery (P < 0.0001). No significant change in PVR was noted during surgery.CONCLUSION:
The PVR/SVR ratio on the day following BTKA was increased. This change may represent the different effects of inflammatory perioperative stresses on the pulmonary and systemic vasculature.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Circulação Pulmonar
/
Artroplastia do Joelho
/
Anestesia Epidural
Tipo de estudo:
Observational_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Clin Anesth
Ano de publicação:
2013
Tipo de documento:
Article