Total hip arthroplasty and chronic obstructive pulmonary disease in a high dependency unit

Abstract

Patients with chronic obstructive pulmonary disease (COPD) undergoing lower limb arthroplasty present an increased risk for intra- and postoperative respiratory complications. The aim of our study is to determine disturbances in arterial blood gases (ABGs) that might occur during and after total hip arthroplasty (THA) procedure in a high dependency unit (HDU). We present the cases of 23 patients with a mean age 71±2 years, grouped in class II and III, according to ASA Physical Status Classification System, who underwent THA under epidural anesthesia. Our study reveals that in the case of patients with COPD who underwent THA, reduction of pO2 was statistically important during and immediately after the surgical intervention, while an important concurrent change of pH and pCO2 was not observed. For a better outcome in patients with COPD who undergo THA, both intra- and postoperative respiratory care in the HDU, with hemodynamic monitoring and avoidance of hypotension and hypoxemia, are essential.