학술논문

Perioperative management of patients with severe pulmonary hypertension in major orthopedic surgery: experience-based recommendations
Document Type
article
Source
GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW, Vol 4, p Doc03 (2015)
Subject
pulmonary hypertension
perioperative management
intraoperative monitoring
local anesthesia
general anesthesia
Surgery
RD1-811
Language
German
English
ISSN
2193-8091
Abstract
Introduction: It is known that pulmonary hypertension is associated with worse outcome in both cardiac and non-cardiac surgery. The aims of our retrospective analysis were to evaluate the outcomes of our patients with pulmonary hypertension undergoing major orthopedic surgery and to give experience-based recommendations for the perioperative management.Material and methods: From 92 patients with pulmonary hypertension undergoing different kinds of surgical procedures from 2011–2014 in a tertiary academic hospital we evaluated 16 patients with major orthopedic surgery for perioperative morbidity and mortality. Results: Regarding the in-hospital morbidity and mortality, one patient died postoperatively due to pulmonary infection and right heart failure (6.25%) and 6 patients suffered significant postoperative complications (37.5%; bleeding = 1, infection = 1, wound healing deficits = 3; dysrhythmia = 1). Conclusion: Our data show that major orthopedic surgery is feasible with satisfactory outcome even in cases of severe pulmonary hypertension by an individualized, disease-adapted interdisciplinary treatment concept.