Tuesday, April 5, 2011

Rapid & severe hypotension

A look at these photographs from the trend graph shows  the following. When there is a slipped arterial blood vessel the result is devastatting.....
Pic1 : Time 13 :07 
 HR 111, BP:  125/74


Pic 2 shows : Time 13:08 
HR ...   BP : 54 / 39 ( Mean BP - 45 )


Pic 3 shows Time 13.09
HR  110 , BP 26/ 19 ( Mean 22 )


PIC : 4  Time  13.10
HR 71 , BP 20 / 13 ( Mean 13 )



PIC : 5  Time 13.11
HR 52 , BP 28/ 13 ( Mean 15 )



PIC 5  shows Time 13.12
HR 55 , BP 55/39
 PIC 6  shows Time 13.13
HR 93 BP 28/ 19
What you have to do is push and push the blood  through the canula by a 20 ml syringe , push and push & push
Theere was no use of ionotrops, no ephedrine, no mephenteramine.......
And after

PIC 7 : Time 13.49
HR 108 BP 72 / 47 ( Mean 58 )

The patient had a remarkable recovery after another 6 hours of  continued surgery under epidural anaesthesia, sedation, 10. 5 Lits of I/V fluid  including 6 Inits of blood transfusion, 2 units of Hesta starch, and an Injection of Lasix.  As the graph shows the Blood pressure  next few hours were around 80 mmhg systolic  and 45 -50 mm Diastolic
Post operatively ,there was no renal shutdown or dysfunction.
This was possible because the hypotension was of short duration ........ and  the mean blood pressure was around 50~60 mmHg.  intraoperatively .