Treatment-pericardial tamponade

• Volume (but be careful b/c overfilling can worsen tamponade) and ⊕ inotropes (avoid βB)
• Avoid vasoconstrictors b/c will ↓ stroke volume & potentially ↓ HR
• Avoid positive pressure ventilation b/c it can further impair cardiac filling (Circ 2006;113:1622)
• Pericardiocentesis (except if due to aortic/myocardial rupture, for which emergent surgery is treatment of choice; if too unstable, consider small pericardiocentesis to prevent PEA)
• Surgical drainage considered if fluid rapidly reaccumulates, loculated, or hemorrhagic