Severe hypercapnia due to pulmonary embolism of

Anesthesia and analgesia · Apr 2004

Case Reports

Severe hypercapnia due to pulmonary embolism of polymethylmethacrylate during vertebroplasty.

Pulmonary polymethylmethacrylate embolism is a rare but potentially fatal complication of percutaneous vertebroplasty. Clinical signs are typical for pulmonary embolism: they include respiratory distress, hypotension, and decreases in end-tidal CO(2). We report a case of fatal pulmonary polymethylmethacrylate embolism during percutaneous vertebroplasty that initially presented with hypertension (arterial blood pressure 190/90 mm Hg), normocardia, and hypercapnia (PaCO(2) 96 mm Hg), along with loss of consciousness. Several pieces of polymethylmethacrylate were found in the pulmonary vasculature at autopsy. ⋯ Osteoporotic spine fractures are increasingly treated by injection of bone cement into the vertebral body. Polymethylmethacrylate embolism is a rare but potentially fatal complication. We report on a case of polymethylmethacrylate embolism that was at first unrecognized because of uncharacteristic signs and symptoms.

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- Kay Stricker, Rene Orler, Katrin Yen, Jukka Takala, and Martin Luginbühl.
- Department of Anesthesiology, University Hospital of Bern, Switzerland. Kay.Stricker@insel.ch
- Anesth. Analg. 2004 Apr 1; 98 (4): 1184-6, table of contents.
UnlabelledPulmonary polymethylmethacrylate embolism is a rare but potentially fatal complication of percutaneous vertebroplasty. Clinical signs are typical for pulmonary embolism: they include respiratory distress, hypotension, and decreases in end-tidal CO(2). We report a case of fatal pulmonary polymethylmethacrylate embolism during percutaneous vertebroplasty that initially presented with hypertension (arterial blood pressure 190/90 mm Hg), normocardia, and hypercapnia (PaCO(2) 96 mm Hg), along with loss of consciousness. Several pieces of polymethylmethacrylate were found in the pulmonary vasculature at autopsy.ImplicationsOsteoporotic spine fractures are increasingly treated by injection of bone cement into the vertebral body. Polymethylmethacrylate embolism is a rare but potentially fatal complication. We report on a case of polymethylmethacrylate embolism that was at first unrecognized because of uncharacteristic signs and symptoms.

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Severe hypercapnia due to pulmonary embolism of polymethylmethacrylate during vertebroplasty.

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