Cardiac Output during Total Hip Replacement in Dogs

2000 ◽  
Vol 13 (02) ◽  
pp. 49-58
Author(s):  
U. Matis ◽  
P. Böttcher ◽  
W. Erhardt ◽  
S. Gantke
Keyword(s):  
Cardiac Output ◽  
Total Hip Replacement ◽  
Doppler Echocardiography ◽  
Hip Replacement ◽  
Reference Method ◽  
Femoral Prosthesis ◽  
Noninvasive Method ◽  
Flow Rates ◽  
Total Hip ◽  
Pulsed Wave Doppler

SummaryTrans-oesophageal pulsed-wave Doppler echocardiography was evaluated as a noninvasive method of determining cardiac output during total hip replacement in 10 dogs. Cardiac output was estimated by determining the crosssectional area of the aorta via caudal transverse echocardiography and the outflow velocity of the ascending aorta via cranial transverse Doppler echocardiography. Thermodilution was used as the reference method. In addition, cardiopulmonary changes, at the time of femoral prosthesis insertion, were determined. Comparison of 160 measurements yielded a correlation coefficient of 0.48. Linear regression analysis revealed the equation, cardiac outputDoppler echocardiography = 0.45 cardiac outputthermodilution + 3.3. In comparison to thermodilution, trans-oesophageal pulsedwave Doppler echocardiography overestimated cardiac output at flow rates less than 61/min and underestimated the cardiac output at flow rates greater than 61/min. There was a significant decrease in the partial pressure of carbon dioxide at end-expiration (PETCO2), the systolic arterial blood pressure (mmHg) and the invasive stroke volume (ml/beat/m2) and a significant increase in the pulmonary vascular resistance (dynes/sec/cm5) immediately after insertion of the femoral prosthesis.The purpose of this study was to evaluate the trans-oesophageal pulsed-wave Doppler echocardiography as a noninvasive method of determining cardiac output in dogs during total hip replacement. Thermodilution was used as the reference method. The correlation coefficient was r = 0.48. In conclusion, this study confirms that the trans-oesophageal Doppler echocardiography is not suitable for measuring the absolute CO-value. This ultrasound technique only allows an approximate estimation of the CO-trend.

ACUTE HYPOTENSION FOLLOWING INSERTION OF FEMORAL PROSTHESIS DURING TOTAL HIP REPLACEMENT

1990 ◽  
Vol 70 (Supplement) ◽  
pp. S368 ◽  
Author(s):  
N. E. Sharrock ◽  
K. V. Sanbom ◽  
B. Urquart ◽  
R. Mineo ◽  
R. Kahn
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Prosthesis ◽  
Total Hip ◽  
Acute Hypotension

Total Hip Replacement in Three Ponies - A Feasibility Study

1996 ◽  
Vol 09 (01) ◽  
pp. 4-9 ◽  
Author(s):  
K.R.E. Squire ◽  
J. P. Toombs ◽  
D.C. Sickle ◽  
W.E. Blevins ◽  
R.B. Clarke ◽  
...  
Keyword(s):  
Femoral Component ◽  
Total Hip Replacement ◽  
Feasibility Study ◽  
Acetabular Component ◽  
Hip Replacement ◽  
Research Model ◽  
Human Beings ◽  
Femoral Prosthesis ◽  
Total Hip ◽  
Press Fit

SummaryTotal hip replacement (THR) using two different human implant designs was performed in three ponies. Pony # 1 sustained a fracture of the ipsilateral femur and was euthanatized 40 hours after implantation of a human selfcentering hip. The same implant, with a modified femoral prosthesis, was used in pony # 2. It luxated initially at 26 hours, was surgically reduced after changing to a smaller diameter acetabular component, and reluxated at day 23 when the pony was euthanatized. A modified femoral component with a press-fit, screw-fixated acetabular prosthesis was inserted in pony # 3. This pony was maintained for 232 days and sustained over 400,000 cycles on the prosthesis by being exercised daily on a mechanical walker. We conclude that THR is feasible in ponies and small horses and would allow this size of animal to be used as a research model for hip replacement in heavy human beings.Total hip replacement (THR) was evaluated in three ponies as a model for studying THR problems in humans and for the management of coxofemo-ral disease in small Equidae. A modified cemented human femoral component, with a press-fit acetabular component, was maintained in one pony for 232 days, sustained over 400,000 cycles, and established the feasibility of THR in this species.

scholarly journals Fracture of the Femoral Prosthesis in Total Hip Replacement According to Charnley

1977 ◽  
Vol 48 (6) ◽  
pp. 650-655 ◽  
Author(s):  
Åke S. Carlsson ◽  
Carl-Fredrik Gentz ◽  
Jan Stenport
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Prosthesis ◽  
Total Hip

Detection of Embolic Events by Capnography and Trans-oesophageal Echocardiography during Total Hip Replacement

1998 ◽  
Vol 11 (02) ◽  
pp. 68-75 ◽  
Author(s):  
U. Matis ◽  
S. Reindl
Keyword(s):  
Carbon Dioxide ◽  
Bone Marrow ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Prosthesis ◽  
Intravascular Coagulation ◽  
Total Hip ◽  
Intramedullary Pressure ◽  
The Right ◽  
Marrow Embolism

SummaryTrans-oesophageal echocardiography and continuous monitoring of the partial pressure of carbon dioxide at end expiration (PETCO2) were performed in 63 dogs during total hip replacement and in three dogs during femoral stem revision. The PET CO2 usually did not change during insertion of the acetabular prosthesis, but in 17.5% of the cases, it decreased by more than 10 mmHg after insertion of the femoral prosthesis. In all of the cases, transoesophageal echocardiography revealed echogenic structures in the right side of the heart, immediately after insertion of the acetabular and of the femoral prostheses. These appeared as either numerous pinpoint echoes, which passed through the right side of the heart in a “snow flurry” like fashion, or more echogenic particles. The embolaemia, seen ultrasonographically, was categorized into one of six grades of severity. Statistical analysis showed significant positive correlations between the severity of the embolaemia and the extent of the decrease in PETCO2 (rs = 0.405; P = 0.001; n = 60), and between the severity of the embolaemia and the duration of the decrease in PETCO2 before it returned to baseline values (rs = 0.345; P = 0.007; n = 60).Trans-oesophageal echocardiography demonstrated that embolaemia was induced during cemented prosthesis insertion. It was proposed that an increase in intramedullary pressure, during insertion, forces bone marrow into the venous circulation. Bone marrow itself can constitute an embolus, but also it may activate intravascular coagulation, thus leading to thromboembolism, in addition to bone marrow embolism. Elongated particulate emboli, up to several centimetres in length, were seen on ultrasonogrammes and were thought to be, at least in part, products of intravascular coagulation. A significant decrease in the platelet concentration in peripheral venous blood, after insertion of the femoral prosthesis, was also indicative of intravascular coagulation. The extent of the impairment of gas exchange was documented by means of capnography. The significant positive correlation between the embolaemia, seen via ultrasonography, and the decrease in PETCO2 strongly suggest a causal relationship between the two variables. The rapid recovery, that occurred in most patients, is attributed to the enormous lytic ability of pulmonary tissue. Prophylactic measures include the maintenance of normovolaemia during the operations, thorough lavage of the intramedullary cavity before prosthesis insertion and steps to prevent an increase in intramedullary pressure during implantation.Using trans-oesophageal echocardiography, embolaemia in the right side of the heart was consistently detected immediately after insertion of cemented acetabular as well as cemented femoral prostheses in dogs. There was a significant correlation between the severity of the embolaemia and the decrease in carbon dioxide at end expiration (PETCO2) after femoral prosthesis insertion.

PULMONARY HYPERTENSION FOLLOWING INSERTION OF FEMORAL PROSTHESIS DURING TOTAL HIP REPLACEMENT

1990 ◽  
Vol 70 (Supplement) ◽  
pp. S367 ◽  
Author(s):  
N. E. Sharrock ◽  
K. V. Sanborn ◽  
P. Castellano ◽  
R. Mineo
Keyword(s):  
Pulmonary Hypertension ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Prosthesis ◽  
Total Hip
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