Hines Cheryl B
is a staff anesthetist at Northport Medical Center in Northport, Alabama.
AANA J. 2018 Dec;86(6):433-441.
Bone cement implantation syndrome (BCIS) is a rare and potentially fatal perioperative complication of cemented bone surgery. Clinically, it can be as benign as transient desaturation or mild hypotension. In its more severe presentation, BCIS can cause serious cardiac dysrhythmias and cardiac arrest, and in cemented hemiarthroplasty for femoral neck fracture, BCIS may carry up to a 16-fold increase in 30-day postoperative mortality. The etiology and pathophysiology of BCIS are not fully established; however, results of studies and clinical reports are consistent, citing right ventricular failure secondary to increased pulmonary artery pressure as the cause of systemic hypotension and sudden cardiac arrest. The purpose of this article was to review the literature for a comprehensive understanding of bone cement and BCIS. This article reviews the history of bone cement and its associated hazards, etiology/ pathophysiology and clinical presentation of BCIS, preoperative assessment and planning for cemented procedures, anesthetic management of BCIS, and the surgeon's role in reducing the risk of BCIS.
骨水泥植入综合征（BCIS）是骨水泥固定手术中一种罕见且可能致命的围手术期并发症。临床上，它可能表现为如短暂性血氧饱和度下降或轻度低血压等良性症状。在更严重的情况下，BCIS可导致严重的心律失常和心脏骤停，在股骨颈骨折的骨水泥半关节置换术中，BCIS可能使术后30天死亡率增加高达16倍。BCIS的病因和病理生理学尚未完全明确；然而，研究结果和临床报告一致，认为肺动脉压力升高继发右心室衰竭是导致全身低血压和心搏骤停的原因。本文的目的是回顾文献以全面了解骨水泥和BCIS。本文回顾了骨水泥的历史及其相关危害、BCIS的病因/病理生理学和临床表现、骨水泥固定手术的术前评估和规划、BCIS的麻醉管理以及外科医生在降低BCIS风险中的作用。
