Resident Readiness General Surgery by Klamen Debra & George Brian & Harken Alden & DaRosa Debra

Author:Klamen, Debra & George, Brian & Harken, Alden & DaRosa, Debra [Klamen, Debra]
Language: eng
Format: mobi, epub
Publisher: McGraw-Hill Medical
Published: 2013-10-30T00:00:00+00:00

Removing only 20 mL should make a huge hemodynamic difference (see Figure 32-1). Conceptually, let’s take some impermissible physiological leaps: by removing 20 mL of pericardial fluid, you permit an additional 20 mL of ventricular end-diastolic filling. The augmented left ventricular end-diastolic volume (LVEDV) translates into 20 mL of additional stroke volume. An additional 20 mL SV × heart rate of 100 equals an increased cardiac output of 2 L! The good news is that you have helped your patient a lot. The bad news is your patient only needs to reaccumulate another 20 mL in order to get back into trouble.

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