Cardiac Tamponade

C. Read, Emer Curran
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Abstract

The incidence of cardiac tamponade following cardiothoracic surgery can reach 6% and can be a life-threatening emergency. The diagnosis of cardiac tamponade in the postoperative setting can be challenging for several reasons, which include the variety of etiologies of shock after cardiac surgery, that the historical clinical signs are seldom seen, and because investigative aids, such as echocardiography, have their limitations. A high index of suspicion of cardiac tamponade is therefore always warranted when assessing a deteriorating patient following cardiac surgery along with an up-to-date knowledge of cardiac arrest after cardiac surgery management. Surgical decompression of the mediastinum by emergency resternotomy is required for 20%–50% of cardiac arrests after cardiac surgery and may need to take place in the critical care environment, so awareness of and training in this procedure are imperative.
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心脏压塞
心包填塞在心胸外科手术后的发生率可达6%,可能是危及生命的紧急情况。心脏填塞的术后诊断可能具有挑战性,原因有以下几个:心脏手术后休克的病因多种多样,历史临床症状很少见,以及超声心动图等调查辅助手段有其局限性。因此,在评估心脏手术后病情恶化的患者以及心脏手术后心脏骤停的最新知识时,高度怀疑心脏填塞总是有理由的。20%-50%的心脏手术后心脏骤停需要紧急胸骨切开术对纵隔进行手术减压,并且可能需要在重症监护环境中进行,因此对该手术的认识和培训是必不可少的。
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