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Pericardiocentesis: differential aspects of a common procedure
A Bastian1, A Meissner, M Lins
1Department of Internal Medicine, 1st Medizinische Klinik, Kiel, Germany.
Objective:
To evaluate the risk and effectiveness of pericardiocentesis in primary and repeat cardiac tamponade.
Design:
Retrospective analysis.
Setting:
Intensive care unit in a medical university hospital.
Patients:
Sixty-three consecutively admitted patients with cardiac tamponade.
Interventions:
In all patients pericardiocentesis was performed via the subxiphoid pathway after echocardiographic detection of the pericardial effusion.
Measurements And Results:
There was no adverse event in patients undergoing primary pericardiocentesis, which was sufficient to resolve pericardial effusion in 51 of 63 patients (81%). However, repeat pericardiocentesis necessitated by the recurrence of symptomatic pericardial effusion yielded suboptimal results in 10 of 12 patients (83%).
Conclusion:
Pericardiocentesis is the treatment of choice for primary symptomatic pericardial effusion. In recurrent pericardial effusion surgical approaches appear to be preferable.