Journal Basic Info

  • Impact Factor: 1.995**
  • H-Index: 8
  • ISSN: 2474-1647
  • DOI: 10.25107/2474-1647
**Impact Factor calculated based on Google Scholar Citations. Please contact us for any more details.

Major Scope

  •  Breast Surgery
  •  Transplant Surgery
  •  Cardiovascular Surgery
  •  Robotic Surgery
  •  Orthopaedic Surgery
  •  Surgical Oncology
  •  Colon and Rectal Surgery
  •  Otolaryngology - Head and Neck Surgery

Abstract

Citation: Clin Surg. 2019;4(1):2683.Research Article | Open Access

Analysis of Preoperative Transthoracic Echocardiographic Parameters in Elderly Patients Undergoing Emergency Orthopedic Surgery

Yasuhiro Watanabe*, Kayoko Matsunuma, Kaoru Watanabe, Hazuki Okawa, Mitsumasa Miyagi and Toru Kaneda

Department of Anesthesia, Japanese Red Cross Shizuoka Hospital, Japan

*Correspondance to: Yasuhiro Watanabe 

 PDF  Full Text DOI: 10.25107/2474-1647.2683

Abstract

The number of elderly patients undergoing orthopedic surgery is continuously increasing in Japan. Very elderly patients have limited cardiopulmonary reserve, and complications may induce intraoperative hemodynamic compromise, particularly in an emergency setting. This retrospective study investigated the hemodynamic characteristics of very elderly patients undergoing either emergency or elective orthopedic surgery using preoperative Transthoracic Echocardiography (TTE). We enrolled 125 patients and compared the following TTE parameters between 64 elective and 61 emergency patients using the 2-D Teichholz method: end-diastolic volume, end-systolic volume, stroke volume, ejection fraction, and fractional shortening. Patients undergoing emergency surgery had a significantly lower stroke volume and stroke index, but a significantly higher heart rate than elective patients. The ejection fraction and fractional shortening were not significantly different, and the cardiac index was almost identical between the two groups. Our results suggest that elderly patients undergoing emergency orthopedic surgery are volume-depleted, and their cardiac output is maintained primarily by compensatory activation of the sympathetic nervous system. Preoperative non-invasive TTE examination was capable of evaluating the hemodynamic status of elderly patients undergoing emergency orthopedic surgery. Both general and regional anesthesia may induce cardiovascular instability to varying degrees. Anesthesiologists should respect the importance of preoperative fluid administration and meticulously monitor and manage these patients perioperatively.

Keywords

Elderly; Emergency treatment; Hip fractures; Preoperative care; Transthoracic echocardiography

Cite the article

Watanabe Y, Matsunuma K, Watanabe K, Okawa H, Miyagi M, Kaneda T. Analysis of Preoperative Transthoracic Echocardiographic Parameters in Elderly Patients Undergoing Emergency Orthopedic Surgery. Clin Surg. 2019; 4: 2683..

Search Our Journal

Journal Indexed In

Articles in PubMed

Sildenafil Transiently Delays Early Alveolar Bone Healing of Tooth Extraction Sockets
 PubMed  PMC  PDF  Full Text
Mesh Sprayer Device with Liquefied Mesh Delivery System: Proposed Alternative for Currently Available Meshes in Hernia Repair and Supplement to Abdominal Closure
 PubMed  PMC  PDF  Full Text
View More...

Articles with Grants

Preoperative Intra-Aortic Balloon Pump Inserted in Acute Myocardial Infarction Patients without Cardiogenic Shock Undergoing Surgical Coronary Revascularization
 Abstract  PDF  Full Text
Is There an Optimal Time-Window for the Minimally Invasive Puncture Evacuation Surgery in Intracerebral Hemorrhage?
 Abstract  PDF  Full Text
View More...