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Chapter 30 - Cardiac Tamponade

from Section 2 - Cardiac, Thoracic, and Vascular Anesthesia

Published online by Cambridge University Press:  03 August 2023

Jessica A. Lovich-Sapola
Affiliation:
Cleveland Clinic, Ohio
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Summary

A 65-year-old female, morbidly obese, smoker (one pack per day for 35 years), with a history of hypertension (HTN), coronary artery disease (CAD), and diabetes mellitus treated with insulin, underwent an uneventful coronary artery bypass graft (CABG). The patient was taken, sedated and intubated, to the intensive care unit (ICU), with dopamine at 5 μg/kg/min and insulin 2 IU/h as continuous infusions. After 3 hours in the ICU, the patient suddenly became tachycardic, and her blood pressure decreased dramatically. She had no response to a higher dose of dopamine and norepinephrine infusion. The surgical fellow on call in the ICU performed an emergent needle pericardial aspiration, which removed 100 cc of fresh blood. The patient was taken emergently to the operating room (OR) on a wide-opened epinephrine drip. After a thoracotomy and pericardiocentesis, the patient’s hemodynamic status improved significantly. How would you have prepared this patient for surgery? What would be your choice of induction drugs, and why?

Type
Chapter
Information
Anesthesia Oral Board Review
Knocking Out The Boards
, pp. 132 - 136
Publisher: Cambridge University Press
Print publication year: 2023

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References

Abdullah, RS. Restoration of circulation after cessation of positive pressure ventilation in a case of “Lazarus Syndrome.Anesth Analg 2001;93:241.CrossRefGoogle Scholar
American Heart Association. American Heart Association 2020 Guidelines for Advanced Cardiovascular Life Support. Dallas: American Heart Association, 2020.Google Scholar
Ben-David, B, Stonebraker, VC, Hershman, R, et al. Survival after failed intraoperative resuscitation: a case of “Lazarus Syndrome.Anesth Analg 2001;92:690–2.Google ScholarPubMed
Gropper, MA. Miller’s Anesthesia, 9th ed. Philadelphia: Elsevier, 2020, pp. 2713–42.Google Scholar
Hoit, BD. Cardiac tamponade. In Yeon SB, ed., UpToDate. www.uptodate.com/contents/cardiac-tamponade (accessed January 3, 2023).Google Scholar
Kaplan, JA, Augoustides, JGT, Manecke, JR, et al. Kaplan’s Cardiac Anesthesia, 7th ed. Philadelphia: Elsevier, 2017, pp. 945–8.Google Scholar
Wilner, DA, Grossman, SA. Pericardiocentesis. In: StatPearls. Treasure Island: StatPearls Publishing, 2022.Google Scholar
Yao, FSF, Hemmings, HC, Malhotra, V, Fong, J. Yao & Artusio’s Anesthesiology: Problem-Oriented Patient Management, 9th ed. Alphen aan den Rijn: Wolters Kluwer, 2021, pp. 279302.Google Scholar

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