Cardiac Tamponade
Considerations
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Emergency with potential for cardiovascular collapse on induction
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Pathophysiologic changes:
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Impaired diastolic filling
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Fixed stroke volume
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Rate-dependent cardiac output
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Hemodynamic goals:
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Full, fast, maintain contractility, maintain SVR
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Etiologies/co-existing diseases:
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Blood: post-cardiac surgery, post-MI, aortic dissection, trauma
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Other: infectious, malignant, radiation, SLE, uremia, autoimmune, pericarditis
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Goals
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If hemodynamically significant, drain prior to general anesthesia & positive pressure ventilation (PPV)
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Spontaneous respiration & avoidance of PPV, coughing, straining
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Cardiovascular goals: fast, full and tight
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Preload: full
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Contractility: maintain, avoid myocardial depressants
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Rate: maintain, possibly ↑
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Rhythm: strict NSR
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Systemic vascular resistance: maintain or ↑
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