E tank
Caution: Paralyzing Agent
- 1,616
- 1,474
- 113
It’s all about volume vs time. A relatively small increase in pericardial volume abruptly, something like 100ml, can cause Tamponade and a slowly accumulating effusion can be something crazy like 1000ml before causing hemodynamic compromise. Also depends on the compliance of the pericardium. Stiff, I.e pericarditis, with effusion is bad.
Absolutely right. An effusion that develops over a month or so, especially in a younger patient can be tolerated extremely well. The patient will feel horrible, but their echo will look like they should have been dead for days. Easily over a liter and a half in the pericardium is well tolerated over a period of time like that. The physiology adapts as if there is chronic RVF and retains volume. This allows for a rise in venous return and what is lost in contractility is "made up" for with volume. Not very efficient but life prolonging.
400-500 cc in 45 minutes, way different situation. No time to adapt to the fall in filling and contractility.