Hemodynamic and blood gas changes during femoral neck prosthetic replacement using a cement gun

We investigated hemodynamic and blood gas changes in eight patients undergoing femoral neck prosthetic replacement. We measured blood pressure, heart rate, pulmonary artery pressure, cardiac output and blood gas before packing bone cement with a cement gun and 5, 10, and 15 min after the insertion of the prosthesis. Significant increases in mean pulmonary artery pressure, and arterial PCO2 were observed, but there were no significant changes in mean arterial pressure, cardiac output, or arterial PaO2. These pulmonary circulatory and blood gas alterations suggested that pulmonary embolism or pulmonary vasospasm had been brought about by the insertion of the prosthesis, but this did not result in systemic changes in the patients in this study. In conclusion, it is recommended to monitor circulatory and respiratory changes closely to detect pulmonary embolism during femoral neck prosthetic replacement using a cement gun.