Pulmonary edema as a complication of pericardial drainage

Pulmonary edema is a rare but potentially lethal complication following the drainage of a pericardial effusion. Certain risk factors have been cited, including markedly increased RA pressure, chronic hypertension, congestive heart failure, angina and valvular disease. Patients with these concurrent problems should be monitored closely using pulmonary artery thermodilution catheters. Aggressive treatment, including diuretics, vasodilators, cardiotonic agents and early intubation with PEEP should be undertaken if the PCWP and PA pressures paradoxically increase after pericardial drainage.