Journal article
The Incidence of Venous Emboli During Extramedullary Guided Total Knee Arthroplasty
Anesthesia and analgesia, v 81(4), pp 757-762
Oct 1995
PMID: 7574006
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
During total knee arthroplasty (TKA), instrumentation of the marrow cavity with an intramedullary guide appears responsible for fatal intraoperative pulmonary embolism.Transesophageal echocardiography demonstrates venous emboli (VE) after tourniquet deflation during intramedullary guided TKA. Extramedullary guides avoid manipulating the marrow cavity. We determined the incidence of VE in 20 patients undergoing extramedullary guided TKA. Recordings of hemodynamic variables, mixed venous oximetry, end-tidal CO2 and N2 tensions, and echocardiograph images occurred after induction of anesthesia, after tourniquet inflation, during cementing, and for 15 min after tourniquet deflation. Large VE appeared in 14 patients and small VE in the other 6 patients. Large VE occurred only after deflation of the tourniquet. Beginning 3 min after tourniquet deflation, mean pulmonary arterial pressures increased from the baseline of 21 +/- 1.0 to 30 +/- 1.3 mm Hg and remained increased for the duration of the procedure. The incidence of large VE with extramedullary guided TKA did not differ compared to the previously reported incidence with intramedullary guided TKA. These data suggest that VE might arise from a thrombogenic effect of the tourniquet rather than from manipulation of the marrow cavity.(Anesth Analg 1995;81:757-62)
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Details
- Title
- The Incidence of Venous Emboli During Extramedullary Guided Total Knee Arthroplasty
- Creators
- Jonathan L Parmet - Drexel UniversityJan C HorrowGregory PharoLawrence CollinsArnold T BermanHenry RosenbergJay C Horrow - Anesthesiology and Perioperative Medicine
- Publication Details
- Anesthesia and analgesia, v 81(4), pp 757-762
- Publisher
- International Anesthesia Research Society
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Anesthesiology and Perioperative Medicine
- Web of Science ID
- WOS:A1995RX47700017
- Scopus ID
- 2-s2.0-0029089658
- Other Identifier
- 991019183961404721
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- Web of Science research areas
- Anesthesiology