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

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-...

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Bibliographic Details
Main Authors: Seyfarth, Hans-Jürgen, Gille, Jochen, Sablotzki, Armin, Gerlach, Stefan, Malcharek, Michael, Gosse, Andreas, Gahr, Ralf H., Czeslick, Elke
Format: Article
Language:deu
Published: German Medical Science GMS Publishing House 2015-01-01
Series:GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
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Online Access:http://www.egms.de/static/en/journals/iprs/2015-4/iprs000062.shtml
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Summary: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.
ISSN:2193-8091