[Verse 1]
Redo sternum, adhesions thick like tar,
Raw dissection surfaces open wide and raw,
Suture lines stitched through calcium and scar,
Fragile tissue tearing where the needle's been before.
Bypass pump drains platelets, leaves 'em dull and spent,
Fibrinogen washed out, clotting power bent,
Haemodilution thins the blood like weak café,
Hypothermia stalls the cascade, cold delay,
Residual heparin lingers in the vein,
Protamine's the answer — reverse that chain.
[Chorus]
Sangre que sube, presión que cae,
(Blood is rising, pressure starts to fail)
Tamponade tightens, el corazón no puede más,
CVP climbing, pulse pressure thin,
Cuidado, mi gente — the clot closes in.
[Verse 2]
Watch the chest tube drainage, first hours tell the tale,
Five to ten mL per kilo per hour — breach that scale,
That's surgical bleeding, call the team, no delay,
But sudden silence, falling pressure — tamponade's in play.
CVP is climbing while the pulse pressure shrinks,
Narrowing gap between the systole and the sink,
Tachycardia gallops, compensating fast,
The right ventricle's thin-walled — built to move, not built to last
When a clot sits on its chest; low-pressure chamber, weak,
First to buckle, first in the whole room to speak.
[Verse 3]
Echo shows the shadow pressing RA, RV wall,
Low-pressure right heart's always first to fall.
Friable — that means it crumbles, won't hold a thread,
Calcified crust shatters where the suture's laid instead.
Diastole can't fill it, the chamber's squeezed so small,
Stroke volume dwindles — equalized pressures, that's the call.
[Chorus]
Sangre que sube, presión que cae,
Tamponade tightens, el corazón no puede más,
CVP climbing, pulse pressure thin,
Cuidado, mi gente — the clot closes in.
[Bridge]
Two to five percent go back beneath the light,
Re-exploration — sternum opened twice tonight,
Massive transfusion brings infection knocking, AKI too,
Mortality climbs when the blood loss breaks on through.
Cuidado, cirujano, el sangrado no perdona,
Trust the drain, trust the numbers, let the data write the song,
No es magia, es monitoreo — watch it close, don't look away,
Tamponade's quiet killer hides in silence, not in display.
[Verse 4]
Point-of-care coagulation, TEG curves on the screen,
Platelet mapping tells you what the naked eye can't glean,
Factor concentrates targeted, no blind transfusion spree,
Cryoprecipitate and fibrinogen, precision therapy.
Desmopressin coaxes vWF from the wall,
Tranexamic acid guards the clot before it starts to fall,
ICU vigilance, serial echoes through the night,
Catch the silent bleeder before it turns to fright.
[Outro]
CVP up, pulse pressure down, tachycardia's the clue,
Friable, dissected, cold and thin — now the picture's true.
Sangre que sube, presión que cae,
Watch the tube, watch the heart — that's how the surgeon stays.