Early recognition of pulmonary dysfunction during intramedullary orthopaedic surgery
The original publication is available at http://www.samj.org.za
Peri-operative partial arterial oxygen tension (Pa(O2)) was monitored in 20 patients undergoing total hip replacement. Three distinct groups emerged on analysis of the arterial oxygen tensions. In group I there was no initial decrease in Pa(O2) but it rose above baseline level towards the end of the procedure. In group II there was a distinct fall in Pa(O2) during the acetabular and femoral stages of the operation. On termination of the procedure Pa(O2) had returned to baseline levels. In group III Pa(O2) values were significantly lower than those in group II during the acetabular and femoral stages and decreased further at the end of the procedure. One patient in group II and 6 in group III developed postoperative pulmonary dysfunction. A progressive deterioration in Pa(O2) during hip replacement without recovery at end of the procedure indicates that the patient is likely to develop postoperative pulmonary dysfunction.
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