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Published on: July 13, 2019
[Pericardiocentesis in a critical care unit]
R Ridruejo Sáez1, B Zalba Etayo
1Unidad de Cuidados Intensivos, Hospital Clínico Universitario Lozano Blesa, Zaragoza.
Insights
Pericardial effusion diagnosis and pericardiocentesis are effective with minimal complications. Neoplastic causes are most frequent, but modern monitoring ensures safe procedures for critically ill patients.
Area of Science:
- Cardiology
- Critical Care Medicine
- Thoracic Surgery
Context:
- Pericardial effusion is a critical condition requiring timely intervention.
- The etiology and outcomes of pericardial effusion can vary significantly.
- Pericardiocentesis is a key procedure for diagnosing and managing pericardial effusion.
Purpose:
- To investigate the etiology, complications, and mortality associated with pericardial effusion.
- To analyze the effectiveness and safety of pericardiocentesis in a critical care setting.
- To understand current trends in pericardial effusion causes and management.
Summary:
- A study of 69 patients with pericardial effusion in a critical care unit revealed neoplastic (27.5%) as the most common etiology, followed by iatrogenic (24.6%) and idiopathic (20.3%).
- Diagnosis was established pre-ICU in 63.8% of cases. Pericardiocentesis, performed within 12 hours in 58% of patients, yielded >500 cc in 53.6% with a complication rate of 10.3%.
- Mortality was 23%, primarily in patients with mechanical pericardial effusion. The study highlights evolving etiologies and the safety of modern pericardiocentesis techniques.
Impact:
- Informs clinical practice regarding the diagnosis and management of pericardial effusion.
- Emphasizes the importance of early diagnosis and intervention in critical care.
- Suggests that advancements in monitoring have improved the safety and efficacy of pericardiocentesis.
Objective:
Study patients diagnosed of pericardial effusion and pericardiocentesis was made. We search the etiology, complications and the cnic's mortality.
Method:
69 patients of Clinic Hospital of Zaragoza admitted in the critical care unit.
Results:
We present 69 patients with 20-87 years old, 21 women and 48 men. The most frequent ethiology was neoplasic, 19 patients(27.5%), in most cases lung and breast cancer; 17 (24.6%) yatrogenic and 14 (20.3%) idiopathic. Diagnosis was made previously at ICU in 63.8% (44 patients). Pericardiocentesis was made in the 12 hours after admission in 40 cases (58%), and was superior than 500 cc in 37(53.6%). We registered pericardiocentesis complications in 7 (10.3%).16 patients dead (23%) most of them with pericardial effusion by mechanic cause.
Conclusion:
Was the pericardial effusion etiology has changed last years, the diagnosis is simply and minimum complications in evacuation, because the means and actual monitorization allow to make pericardiocentesis in optimum conditions.
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