Hypovolemic Shock in Total Knee Arthroplasty
Authors: Tanongsak Homsapaya, M.D., Pakasith Anahanlipaiboon, M.D., Witoon Lairungruang, M.D.
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Objective: Patients who receive total knee arthroplasty, which is a procedure that typically results in large amount of blood
loss, have a higher probability of experiencing hypovolemic shock which can result in life threatening complications for the
patient. Based on study and practice, the amount of blood loss can vary significantly. Currently, there are no other studies
related to hypovolemic shock after total knee arthroplasty. The objective of this research is to study protective measures against
hypovolemic shock after severe loss of blood which can occur after total knee artrhoplasty surgery and to ensure the safety
of the patient post total knee arthroplasty surgery.
Methods: This is a retrospective study. Study subjects were patients who received total knee arthroplasty surgery at Jainad
Narendra Hospital from October 1, 2007 through March 31, 2010. The total number of study subjects enrolled was 124 patients
and 139 subjects. The study focused on the occurrence of hypovolemic shock after knee artrhoplasty surgery. Hypovolemic
shock is a state of decreased blood volume characterized by a blood pressure lower than 80/60 mmHg and heart rate of over
100 beats per minute.
Results: Out of the 139 subjects, 20 subjects experienced hypovolemic shock after total knee arthroplasty surgery and 119
subjects did not. Differences in the amount of blood given to patients who experienced hypovolemic shock and those who did
not experience hypovolemic shock did not indicate any statistical significance with a p-value <0.05. Differences in hematocrit
levels pre-operation and two hours post-operation, surgical time, and amount of blood loss post-operation did not indicate any
statistical significance with p-value < 0.05 when comparing patients who expe-rienced hypovolemic shock and those that did
not after total knee arthroplasty surgery.
Conclusion: Total knee arthroplasty surgery can cause severe blood loss that can lead to hypovolemic shock, which can cause
life threatening complications for the patient. Therefore, it is critical to maintain proper care and close observation for postsurgical
patients who received the procedure 4 hours prior.