scholarly journals Continuous Measurement of Arterial Blood Gas Status during Total Hip Replacement: A Prospective Study

1996 ◽  
Vol 24 (3) ◽  
pp. 334-341 ◽  
Author(s):  
B. Venkatesh ◽  
D. W. Pigott ◽  
A. Fernandez ◽  
S. P. Hendry

The arterial blood gas chemistry was measured continuously in ten patients during primary cemented total hip replacement in order to define more precisely the patterns of changes in blood gases during various stages of the operation. All ten patients demonstrated significant drops in PaO2 after femoral cement implantation and nine of the ten after acetabular cement implanation. The mean drop in PaO2 following acetabular cement expressed as mean ± SD was 18±8 mmHg (16±6%) (P<0.05) and femoral cement application was 25±11 mmHg (23±9%) (P<0.05). For changes in PaO2 there were corresponding drops in SpO2 in all patients with the femoral cement and in eight patients with the acetabular cement. The mean drop in SpO2 following the application of acetabular and femoral cements respectively were 1.7±1.5% and 3±2.45%. No changes in blood PaO2 were observed during dislocation of the hip joint or reaming of acetabulum and femur. In vitro studies revealed no effect of the liquid monomer or the cured cement on the performance of the Clark electrode of the sensor. We suggest that significant drops in PaO2 occur with both acetabular and femoral cement implantation and that the derangements in blood PaO2 last longer than detected by pulse oximetry following cement implantation.

2009 ◽  
Vol 130 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Jean-Michel Laffosse ◽  
Vincent Minville ◽  
Philippe Chiron ◽  
Aline Colombani ◽  
Claude Gris ◽  
...  

Arterial blood gas (ABGs) analysis forms the cornerstone of emergency respiratory investigation. In many situations values obtained dictate management strategy and facilitate decision-making. It is an uncomfortable procedure for the patients and if repeated ABGs are required, consider whether less invasive measures, such as respiratory rate, pulse oximetry or capillary blood gas measurements could be used....


1987 ◽  
Vol 69-B (1) ◽  
pp. 64-66 ◽  
Author(s):  
N Waterhouse ◽  
AR Beaumont ◽  
K Murray ◽  
P Staniforth ◽  
MH Stone

1986 ◽  
Vol 9 (6) ◽  
pp. 427-432 ◽  
Author(s):  
R. Fumagalli ◽  
T. Kolobow ◽  
P. Arosio ◽  
V. Chen ◽  
D.K. Buckhold ◽  
...  

A total of 44 preterm fetal lambs at great risk of developing respiratory failure were delivered by Cesarean section, and were then managed on conventional mechanical pulmonary ventilation. Fifteen animals initially fared well, and 14 of these were long term survivors. Twenty-nine other lambs showed a progressive deterioration in arterial blood gases within 30 minutes of delivery, of which 10 lambs were continued on mechanical pulmonary ventilation (20% survival), while the remaining 19 lambs were placed on an extracorporeal membrane lung respiratory assist (79% survival). Extracorporeal membrane lung bypass rapidly corrected arterial blood gas values, and permitted the use of high levels of CPAP instead of the continuation of mechanical pulmonary ventilation at high peak airway pressures. Improvement in lung function was gradual, and predictable. Early institution of extracorporeal respiratory assist using a membrane artificial lung rapidly corrected arterial blood gas values and significantly improved on neonate survival.


1975 ◽  
Author(s):  
Duncan P. Thomas ◽  
S. Sagar ◽  
V. V. Kakkar

Plasma heparin and activated Factor X inhibitor (Xal) levels were measured in 25 patients undergoing total hip replacement. Blood samples were taken before, during and for 5 days after operation. In patients receiving heparin prophylaxis, over 50% of samples taken four hours after a subcutaneous injection of 5,000 units had no detectable plasma heparin; in none of the remaining samples did the level exceed 0.04 units per ml. In patients who developed deep vein thrombosis (DVT) postoperatively, as detected by 125-I-labelled fibrinogen and confirmed by venography, the mean preoperative level of Factor XaI was 73.5% (S. E. M.±6.9). In those patients who did not develop DVT, the mean preoperative level was 101.5% (S. E.M.±4.3) (P > 0.01).It is concluded that a regimen of 5,000 units 8-hour’ly does not give sustained plasma heparin levels after total hip replacement, which may in part explain the reduced effectiveness of low-dose heparin in preventing DVT in patients undergoing hip surgery. Low levels of Factor XaI in the immediate preoperative period correlated well with the subsequent development of thrombosis in these patients.


2017 ◽  
Vol 42 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Jan Philippe Kretzer ◽  
Ulrike Mueller ◽  
Marcus R. Streit ◽  
Hartmuth Kiefer ◽  
Robert Sonntag ◽  
...  

Author(s):  
L Brown ◽  
H Zhang ◽  
L Blunt ◽  
S Barrans

The stem-cement interface experiences fretting wear in vivo due to low-amplitude oscillatory micromotion under physiological loading, as a consequence it is considered to play an important part in the overall wear of cemented total hip replacement. Despite its potential significance, in-vitro simulation to reproduce fretting wear has seldom been attempted and even then with only limited success. In the present study, fretting wear was successfully reproduced at the stem-cement interface through an in-vitro wear simulation, which was performed in part with reference to ISO 7206-4: 2002. The wear locations compared well with the results of retrieval studies. There was no evidence of bone cement transfer films on the stem surface and no fatigue cracks in the cement mantle. The cement surface was severely damaged in those areas in contact with the fretting zones on the stem surface, with retention of cement debris in the micropores. Furthermore, it was suggested that these micropores contributed to initiation and propagation of fretting wear. This study gave scope for further comparative study of the influence of stem geometry, stem surface finish, and bone cement brand on generation of fretting wear.


2012 ◽  
Vol 3 (2) ◽  
pp. 3 ◽  
Author(s):  
Philipp Gebel ◽  
Markus Oszwald ◽  
Bernd Ishaque ◽  
Gaffar Ahmed ◽  
Recha Blessing ◽  
...  

The purpose of this study was to analyse a new concept of using the the minimally invasive direct anterior approach (DAA) in total hip replacement (THR) in combination with the leg positioner (Rotex- Table) and a modified retractor system (Condor). We evaluated retrospectively the first 100 primary THR operated with the new concept between 2009 and 2010, regarding operation data, radiological and clinical outcome (HOOS). All surgeries were perfomed in a standardized operation technique including navigation. The average age of the patients was 68 years (37 to 92 years), with a mean BMI of 26.5 (17 to 43). The mean time of surgery was 80 min. (55 to 130 min). The blood loss showed an average of 511.5 mL (200 to 1000 mL). No intra-operative complications occurred. The postoperative complication rate was 6%. The HOOS increased from 43 points pre-operatively to 90 (max 100 points) 3 months after surgery. The radiological analysis showed an average cup inclination of 43° and a leg length discrepancy in a range of +/- 5 mm in 99%. The presented technique led to excellent clinic results, showed low complication rates and allowed correct implant positions although manpower was saved.


2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Azam Faraji ◽  
Alireza Khatony ◽  
Gholamreza Moradi ◽  
Alireza Abdi ◽  
Mansour Rezaei

Aim. This study was aimed at comparing the effects of the open and closed suctioning techniques on the arterial blood gas values in patients undergoing open-heart surgery.Methods. In a clinical trial, we recruited 42 patients after open-heart surgery in an educational hospital. Each patient randomly underwent both open and closed suctioning. ABGs, PaO2, SaO2, PaCO2, were analyzed before and one, five, and fifteen minutes after each suctioning episode.Results. At first the pressure of oxygen in arterial blood increased; however, this increase in the open technique was greater than that of the closed system(P<0.001). The pressure of oxygen decreased five and fifteen minutes after both suctioning techniques(P<0.05). The trends of carbon dioxide variations after the open and closed techniques were upward and downward, respectively. Moreover, the decrease in the level of oxygen saturation five and fifteen minutes after the open suctioning was greater than that of the closed suctioning technique(P<0.05).  Conclusion. Arterial blood gas disturbances in the closed suctioning technique were less than those of the open technique. Therefore, to eliminate the unwanted effects of endotracheal suctioning on the arterial blood gases, the closed suctioning technique is recommended.


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