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GMS Interdiscip Plast Reconstr Surg DGPW. 2015 Jan 14;4:Doc03. doi: 10.3205/iprs000062. eCollection 2015.

Perioperative management of patients with severe pulmonary hypertension in major orthopedic surgery: experience-based recommendations.

Author information

1
Medical Clinic and Polyclinic I, Department of Pneumology, Universitätsklinikum Leipzig AöR, Leipzig, Germany.
2
Clinic for Anesthesiology, Critical Care Medicine and Pain Therapy, St. Georg Hospital Leipzig, Germany.
3
Clinic for Orthopedic and Reconstructive Surgery, St. Georg Hospital Leipzig, Germany.
4
Clinic for Anesthesiology and Critical Care Medicine, Martin-Luther-University of Halle-Wittenberg, Halle/Saale, Germany.

Abstract

in English, German

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.

KEYWORDS:

general anesthesia; intraoperative monitoring; local anesthesia; perioperative management; pulmonary hypertension

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