Intraoperative hemodynamic changes during total knee replacement

Abstract

Total knee replacement with the use of bone cement to fix the prosthesis induces an immediate, important pulmonary vascular obstruction and decrease in left ventricular performance after release of the tourniquet. Such hemodynamic changes may explain the cardiac arrest previously reported, particularly when intravascular volume expansion is inadequate to correct the hypovolemia and the increase in right ventricular afterload induced by the release of the tourniquet.