We have located links that may give you full text access.
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Hemodynamic effects of volume expansion in patients with cardiac tamponade.
Circulation 2008 March 25
BACKGROUND: Volume expansion has been proposed as an alternative treatment for cardiac tamponade; however, the scientific evidence for this recommendation is very poor.
METHODS AND RESULTS: Forty-nine unselected patients (23 males; age 55+/-16 years) with large pericardial effusion and hemodynamic tamponade underwent fluid overload with intravenous administration of 500 mL of normal saline over 10 minutes. Cardiac index and intrapericardial, left ventricular end-diastolic, right atrial, and right ventricular end-diastolic pressures were measured during basal state (tamponade), after fluid overload, and after pericardiocentesis. Twenty-eight patients (57%) had physical signs of tamponade, and 10 (20%) were hypotensive. Size of pericardial effusion was 31+/-13 mm. Initial mean arterial pressure was 88+/-21 mm Hg, and cardiac index was 2.46+/-0.80 L x min(-1) x m(-2). Intrapericardial pressure was 8.31+/-5.98 mm Hg. Volume expansion caused a significant increase in mean arterial pressure (from 88+/-21 to 94+/-23 mm Hg, P=0.003) and cardiac index (from 2.46+/-0.80 to 2.64+/-0.68 L x min(-1) x m(-2), P=0.013), as well as in intrapericardial pressure (from 8.31+/-5.98 to 11.02+/-6.27 mm Hg, P=0.0001), right atrial pressure (from 9.76+/-5.91 to 12.82+/-6.34 mm Hg, P=0.0001), and left ventricular end-diastolic pressure (from 14.21+/-5.97 to 19.48+/-6.19 mm Hg, P=0.0001). Cardiac index increased by >10% in 23 patients (47%), remained unchanged in 11 (22%), and decreased in 15 (31%). No patient developed clinical complications. Predictors of this favorable response were systolic blood pressure <100 mm Hg and low cardiac index.
CONCLUSIONS: Approximately one half of patients with cardiac tamponade develop a significant increase in cardiac output after volume overload. Low systolic blood pressure (<100 mm Hg) at baseline was the simplest clinical finding that was predictive of this favorable response.
METHODS AND RESULTS: Forty-nine unselected patients (23 males; age 55+/-16 years) with large pericardial effusion and hemodynamic tamponade underwent fluid overload with intravenous administration of 500 mL of normal saline over 10 minutes. Cardiac index and intrapericardial, left ventricular end-diastolic, right atrial, and right ventricular end-diastolic pressures were measured during basal state (tamponade), after fluid overload, and after pericardiocentesis. Twenty-eight patients (57%) had physical signs of tamponade, and 10 (20%) were hypotensive. Size of pericardial effusion was 31+/-13 mm. Initial mean arterial pressure was 88+/-21 mm Hg, and cardiac index was 2.46+/-0.80 L x min(-1) x m(-2). Intrapericardial pressure was 8.31+/-5.98 mm Hg. Volume expansion caused a significant increase in mean arterial pressure (from 88+/-21 to 94+/-23 mm Hg, P=0.003) and cardiac index (from 2.46+/-0.80 to 2.64+/-0.68 L x min(-1) x m(-2), P=0.013), as well as in intrapericardial pressure (from 8.31+/-5.98 to 11.02+/-6.27 mm Hg, P=0.0001), right atrial pressure (from 9.76+/-5.91 to 12.82+/-6.34 mm Hg, P=0.0001), and left ventricular end-diastolic pressure (from 14.21+/-5.97 to 19.48+/-6.19 mm Hg, P=0.0001). Cardiac index increased by >10% in 23 patients (47%), remained unchanged in 11 (22%), and decreased in 15 (31%). No patient developed clinical complications. Predictors of this favorable response were systolic blood pressure <100 mm Hg and low cardiac index.
CONCLUSIONS: Approximately one half of patients with cardiac tamponade develop a significant increase in cardiac output after volume overload. Low systolic blood pressure (<100 mm Hg) at baseline was the simplest clinical finding that was predictive of this favorable response.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app