Polymethylmethacrylate causes prolonged pulmo-nary hypertension during fat embolism: A study in sheep

Figures & data

Table 1.  Cardiovascular data for the PMMA and wax groups prior to vertebroplasty (pre-VP) and following vertebro-plasty (peak at 0.5 min to 10 min). Values are mean (SE)

	n		Pre-VP	Peak	Min 1	Min 3	Min 5	Min 10
MABP (mm Hg)	8	PMMA	90 (5.5)	48 (6.0)^a	85 (9.0)	98 (7.1)	86 (7.4)	79 (5.4)
	8	Wax	89 (7.4)	53 (9.4)^a	92 (8.3)	99 (8.0)	91 (7.4)	83 (7.7)
MPAP (mm Hg)	6	PMMA	19.8 (2.8)	40 (5.4) a	30.6 (3.5)^b	29.6 (3.4) b	28.1 (3.1) b	23.4 (3.3)
	6	Wax	18.9 (3.6)	37 (6.3)^a	26.3 (3.8)^b	22.1 (4.3)	22.4 (3.3)	20.6 (2.4)
MCVP (mm Hg)	6	PMMA	6 (1.0)	12.1 (1.8)^a	8.5 (1.7)	8.1 (1.2)	7.6 (1.2)	6.2 (1.3)
	6	Wax	6.5 (1.3)	10.8 (1.4)^a	8.3 (0.9)^b	7.6 (1.1)	7 (1.9)	6.5 (0.8)
HR (beats/min)	8	PMMA	118 (7.6)	118 (9.6)	115 (7.9)	117 (7.9)	113 (6.5)	114 (7.3)
	8	Wax	121 (7.4)	115 (8.8)	117 (7.5)	118 (7.5)	121 (7.7)	118 (8.1)
Q (L/min)	8	PMMA	6.4 (0.6)	2.5 (0.4)	a 5 (0.6)^b	5.2 (0.7)^b	5.5 (0.6)	5.9 (0.6)
	8	Wax	5.7 (0.7)	3.5 (0.7)^a	5.3 (0.5)	5.6 (0.5)	6.4 (0.6)	6 (0.6)
LVDP (mm Hg)	5	PMMA	2 (2.2)	3.6 (2.4)	4.4 (2.3)	4 (2.7)	3.6 (2.6)	4 (2.1)
	5	Wax	3.2 (2.3)	3.2 (2.2)	3.8 (2.4)	4.6 (2.6)	4.0 (1.4)	2.6 (0.7)
SvO2(%)	5	PMMA	77 (1.0)	71 (1.5)^a	72 (1.7)^b	75 (0.5)	76 (i0.9)	76 (1.4)
	5	Wax	77 (1.6)	72 (2.5)^a	73 (2.6)	75 (1.9)	77 (1.2)	77 (0.9)
SVR (dyne s/cm5)	5	PMMA	1144 (296)	1363 (103)	1339 (53)	1379 (49)	1193 (33)	1015 (47)
	5	Wax	955 (122)	1034 (278)	1186 (169)^b	1261 (214)^b	1003 (158)	942 (140)
PVR (dyne s/cm5)	5	PMMA	266 (26)	1222 (117)^a	549 (53)^a	459 (49)^a	426 (33)^a	336 (47)
	5	Wax	276 (49)	1031 (120)^a	412 (56)^a	346 (62)	308 (52)	314 (42)

^asignificantly different from pre-VP value (p < 0.001).

^bsignificantly different from pre-VP value (p < 0.05).

Table 2.  The 95% confidence intervals for selected cardiovascular parameters of the PMMA and wax groups prior to vertebroplasty (pre-VP) and following vertebroplasty (peak at 0.5 min to 10 min)

	n		Pre-VP	Peak	Min 1	Min 3	Min 5	Min 10
MABP (mm Hg)	8	PMMA	79–101	36.3–60	67–102	84–112	71–100	69–90
	8	Wax	74–104	34.6–72	76–108	83–114	77–106	77–106
MPAP (mm Hg)	6	PMMA	14.3–25.3	29.6–51	23.9–37.4	23.0–36.2	22.0–34.2	16.8–29.9
	6	Wax	11.9–25.8	23.8–53	18.9–33.6	13.6–30.6	15.9–28.8	15.8–28.9
MCVP (mm Hg)	6	PMMA	4–8	8.6–15.5	5.2–11.9	5.8–10.4	5.3–9.8	3.7–8.7
	6	Wax	4–9	8.1–13.5	6.6–10	5.5–9.7	5.5–8.5	5.5–8.4
Q (L/min)	8	PMMA	5.1–7.6	1.6–3.3	3.8–6.1	3.9–6.5	4.5–6.6	4.8–7.0
	8	Wax	4.3–7.1	2.1–4.9	4.3–6.2	4.6–6.6	5.2–7.7	5.2–7.6

Figure 1. Mean arterial blood pressure (MABP), mean central venous pressure (MCVP), cardiac output and venous O₂saturation recorded prior to vertebroplasty (time 0) and 0.5, 1, 3, 5, and 10 min following vertebroplasty with PMMA and bone wax. Asterisks indicate values that are significantly different from the preinjection (time 0) value (p < 0.05).

Figure 2. Mean pulmonary artery pressure (MPAP) and PVR recorded prior to vertebroplasty (time 0) and following ver-tebroplasty with PMMA and bone wax.Asterisks indicate values that are significantly different from the preinjection (time 0) value (p < 0.05).