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I just saw a case where the patient had severe tamponade, along with a giant plural effusion, all due to metastatic adenocarcinoma.
The right side of the heart was barely visible on TEE, and the effusion was gigantic. It was amazing seeing the effusion shrink and the heart expand as the surgeon drained it. The heart was a mess, mostly because of the tamponade, but also because it was riddled with tumors. Poor guy.
Question: Instead of the whole "prepare the patient awake and have the surgeon ready to cut as soon as you induce," why dont you use something that does not lower BP like ketamine?
The right side of the heart was barely visible on TEE, and the effusion was gigantic. It was amazing seeing the effusion shrink and the heart expand as the surgeon drained it. The heart was a mess, mostly because of the tamponade, but also because it was riddled with tumors. Poor guy.
Question: Instead of the whole "prepare the patient awake and have the surgeon ready to cut as soon as you induce," why dont you use something that does not lower BP like ketamine?