Grade III bone cement implantation syndrome in malignant lung cancer patient: a case report

Abstract

BackgroundBone cement implantation syndrome is a known complication causing mortality during perioperative period particularly in patients with malignancy. With rise in aging population with malignancy in low income country, the syndrome is more likely to be encountered.Case presentationWe present a case of 66 years old male patient with metastatic bronchogenic carcinoma of lung with pathological proximal femur fracture of left hip that underwent a cemented endoprosthesis under combined spinal epidural anesthesia who succumbed to intraoperative mortality due to grade III bone cement implantation syndrome even after aggressive fluid resuscitation, vasopressor use, and mechanical ventilation.ConclusionsCareful identification of risk factors with aggressive vigilance and intervention in part of surgeons and anesthesia both during intraoperative and postoperative period can mitigate the risk of bone cement implantation syndrome.

Hemodynamic changes and related factors in bone cement implantation syndrome in knee arthroplasty candidates

“…Therefore, after providing proper ventilation and keeping the airway open, monitoring hemodynamic status is incredibly important and considered by anesthesiologists as a major challenge in anesthesia management. Due to its importance, hemodynamic status is continuously monitored during operation to report the slightest changes (10). Various factors can affect hemodynamic status during operation, including bleeding, extent of surgical incision, blood transfusion, injection of anesthetics, and intraoperative procedures.…”

Evaluation of hemodynamic goal-directed therapy to reduce the incidence of bone cement implantation syndrome in patients undergoing cemented hip arthroplasty – a randomized parallel-arm trial

“…With regards to already known independent predictors of BCIS (ASA ≥ 3, femoral neck fracture, medication with diuretics and anticoagulation) randomization in this study appears adequate [ 5 , 9 , 32 ]. The high percentage of patients classified as ASA 3 and 4 in this study makes the data presented reliable.…”

“…Donaldson and colleagues established a severity classification of BCIS according to oxygen desaturation and hypotension (Table 1 ) [ 6 ]. Patients with BCIS grade 2 and 3 showed a 16-fold increase in 30 day postoperative mortality compared to those with BCIS grade 1 [ 5 , 9 ]. Several independent predictors for severe BCIS have been identified: ASA grade 3–4, chronic obstructive pulmonary disease and preoperative medication with diuretics or warfarin [ 5 ].…”

Temas transversais em saúde coletiva

“…Descreve-se que o principal momento do estabelecimento da síndrome é durante o período intraoperatório, na fase de colocação do cimento ósseo, ou durante a implantação da prótese, redução da fratura e menos frequentemente na deflação do torniquete. Dessa forma, tanto o cirurgião como o anestesista devem estar observando a hemodinâmica do paciente, haja vista o rápido desenvolvimento da desordem, devendo instituir o tratamento clínico (HAMAL et al, 2018).…”