Title: Perioperative Management of Pulmonary Embolism Following Bipolar Cemented Hemiarthroplasty- A Case Report
Authors: Dr Nisha Krishnaraj, Dr Afreen Nahar R, Dr Arun Kumar
DOI: https://dx.doi.org/10.18535/jmscr/v10i1.27
Abstract
Introduction
Perioperative pulmonary emboli (PE) in trauma patients are common. Pulmonary embolism is a potentially lethal complication and accounts for many cases of postoperative deaths each year. Pulmonary embolism (PE) describes an obstruction of the pulmonary arterial tree with abnormal material (thrombus, tumour, air or fat), usually originating somewhere else in the body. Patients can present acutely (immediately after the event), sub-acutely (within days/weeks after the embolism) or chronically (years after theembolism). The most common cause of acute PE is the migration of thrombus from veins (or right heart) to the pulmonary arteries. The risk factors for pulmonary embolism are immobility, malignancy, surgery, hospitalization, pregnancy, advancing age, trauma, infection, oestrogen, smoking, obesity, blood transfusion, hyper viscosity syndromes. The Virchow triad risk factors of pulmonary embolism are venous stasis, endothelial injury and hypercoagulable states. Patients with trauma, particularly to the long bones and pelvis, who are bedridden and immobile for a prolonged period of time areat greatest risk of developing venous thromboembolism. The following case report describes the anaesthetic events and management of a patient posted for bipolar hemiarthroplasty who developed pulmonary embolism intra operatively immediately following cementing.
