Related Experiment Video
Updated: May 16, 2025
Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model
Published on: May 26, 2023
Risk Factors for Pericardiocentesis After Paediatric Cardiac Surgery
Vikhashni Nagesh1, Alyssa Chappell1, Jesse Batara2
1Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Insights
Postoperative anticoagulation use in children after cardiac surgery is linked to needing pericardiocentesis for pericardial effusions. This finding helps predict which young patients may require drainage for fluid buildup around the heart.
Area of Science:
- Cardiology
- Pediatric Surgery
- Critical Care Medicine
Background:
- Pericardial effusions are a frequent complication following pediatric cardiac surgery.
- Cardiac tamponade is a rare but serious consequence of these effusions.
- Predicting the need for pericardiocentesis in pediatric patients with effusions is challenging.
Purpose of the Study:
- To identify risk factors associated with the requirement for pericardiocentesis in children with postoperative pericardial effusions.
- To investigate predictors of pericardiocentesis in the pediatric cardiac surgery population.
Main Methods:
- A case-control study was conducted involving pediatric patients who underwent cardiac surgery.
- Cases were defined as patients requiring pericardiocentesis within two months post-surgery.
- Controls were patients with effusions who did not require pericardiocentesis, matched 2:1 by age and surgical year.
Main Results:
- The study included 42 cases and 84 controls.
- Postoperative use of anticoagulation or antiplatelet agents was independently associated with effusions requiring drainage (OR: 3.6, P < 0.01).
- Prednisone use and a history of pericardial effusion showed trends towards association but did not reach statistical significance.
Conclusions:
- Postoperative anticoagulation is a significant independent risk factor for requiring pericardiocentesis in pediatric cardiac surgery patients.
- The type of surgical procedure performed was not found to be associated with the need for pericardial effusion drainage.
Background:
Pericardial effusions are common after paediatric cardiac surgery and can lead to cardiac tamponade in a small minority. However, it is difficult to predict which patients with an effusion will require pericardiocentesis. Therefore, among children with a postoperative effusion, we sought to identify risk factors for requiring pericardiocentesis.
Methods:
We conducted a case-control study including paediatric patients who underwent cardiac surgery between January 1, 2005, and July 1, 2020, at the Stollery Children's Hospital. Cases were defined as those who underwent pericardiocentesis within 2 months of cardiac surgery and were compared with controls who had an effusion but did not require pericardiocentesis. Controls were matched 2:1 to cases based on age and year of surgery.
Results:
There were 42 cases and 84 controls. The median age at surgery was 3.0 years (interquartile range [IQR]: 0.5-6.4 years) among cases and 2.2 years (IQR: 0.4-5.8 years) among controls. The median weight at surgery was 13.5 kg (IQR: 6.4-18.0 kg) among cases and 13.5 kg (IQR: 4.9-23.1 kg) among controls. The use of anticoagulation or antiplatelet agents (odds ratio [OR]: 3.6, 95% confidence interval [CI]: 1.5-8.2, P < 0.01) in the postoperative period was independently associated with effusions requiring drainage. The use of prednisone postoperatively (OR: 3.3, 95% CI: 0.8-14.0, P = 0.10) and a history of previous pericardial effusion (OR: 4.7, 95% CI: 0.9-25.6, P = 0.08) were associated with a higher odds of pericardiocentesis but did not reach statistical significance.
Conclusions:
The use of postoperative anticoagulation was independently associated with the need for pericardiocentesis. Type of surgical procedure was not associated with the need for drainage.
More Related Videos
07:39Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
05:31Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
Published on: June 8, 2022
Related Concept Videos
01:26Endoscopic Studies II: Thoracocentesis
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
01:17Assessment of apical pulse
Assessing the apical pulse is a critical nursing procedure, particularly indicated for: