- Over the next 20 minutes,
the lobe is successfully isolated and removed. As
the pathology report is awaited confirming that
the surgical margins are free of tumor, the
patient's vital signs began to sag.
- The blood-pressure has
dropped in 90/60 and heart rate has decreased to
50 bpm with occasional runs of complexes without
P waves.
- The isoflurane level is
markedly reduced and the epidural infusion is
stopped.
- A 300 ml bolus of lactated
Ringer's solution is given. Fluid replacement for
the estimated 300 mills of blood loss, third
space loss, and over night deficit was reviewed
and thought to be adequate.
- the blood-pressure
continues to sag to 85/60 with a heart rate
occasionally to 47 bpm with more frequent loss of
P waves. The ST-T wave trending on the ECG is
solidly isoelectric throughout
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