Pericardiocentesis Indications and Complications: A Retrospective Observational Study in a Tertiary Care Hospital in Karachi, Pakistan

Baqi, Abdul; Ahmed, Intisar

doi:10.7759/cureus.10102

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…A subcostal, apical, or parasternal approach can be used, depending on the ultrasound findings [ 21 , 22 ]. Using echocardiography, success rates are high and complication rates are very low, with major complication rates of 1–3% (although these series are not restricted to pericardiocentesis performed in the resuscitation setting) [ 23 , 24 , 25 , 26 , 27 ].…”

Section: Use Of Ultrasound For Diagnosis In Resuscitationmentioning

confidence: 99%

Ultrasound during Advanced Life Support—Help or Harm?

Goudie,

Blaivas,

Horn

et al. 2024

Diagnostics

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Ultrasound is used in cardiopulmonary resuscitation (CPR) and advanced life support (ALS). However, there is divergence between the recommendations of many emergency and critical care societies who support its use and the recommendations of many international resuscitation organizations who either recommend against its use or recommend it only in limited circumstances. Ultrasound offers potential benefits of detecting reversable causes of cardiac arrest, allowing specific interventions. However, it also risks interfering with ALS protocols and increasing unhelpful interventions. As with many interventions in ALS, the evidence base for ultrasound use is weak, and well-designed randomized trials are needed. This paper reviews the current theory and evidence for harms and benefits.

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Section: Use Of Ultrasound For Diagnosis In Resuscitationmentioning

confidence: 99%

Ultrasound during Advanced Life Support—Help or Harm?

Goudie,

Blaivas,

Horn

et al. 2024

Diagnostics

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“…A recent study in our region has reported malignancy as the most common cause of cardiac tamponade and pericardial effusion requiring pericardiocentesis [ 9 ]. However, patients with malignant pericardial effusion require repeat pericardiocentesis or a pericardiac window if they develop recurrent effusion.…”

Section: Introductionmentioning

confidence: 99%

Best management of patients with malignant pericardial effusion: a comparative study between imaging-guided pericardiocentesis and surgical pericardial window

2023

J Clin Transl Res

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Background: The clinical course of malignancies is frequently complicated by third spacing in body cavities, including pericardial effusion. What remains the optimal management for malignant pericardial effusion is a dilemma. Aim: We aimed to compare 30-day outcomes of imaging-guided pericardiocentesis and surgical pericardial window in patients with malignant pericardial effusion. Methods: A retrospective observational study was done at a tertiary care hospital. We reviewed hospital record files of 91 consecutive patients admitted with malignant pericardial effusion from January 2010 to December 2019 and requiring imaging-guided pericardiocentesis or pericardial window. Results: A total of 71 patients were included in the final analysis. Most patients were male (68%). The mean age was 45 years. Hypertension was the most common comorbid condition. Lymphoma or leukemia (39%) was the most common cause of malignant pericardial effusion followed by lung cancer (28%). About 57.7% of patients underwent pericardiocentesis, and the remainder underwent surgical pericardial window (42.3%). The overall procedural success was 97.2%, and the overall mortality was 5.6%. The success rate was similar when pericardiocentesis was compared with the surgical pericardial window ( p = 0.22). The length of hospital stay was higher in patients undergoing pericardial window ( p = 0.007), whereas the re-accumulation rate was higher in the pericardiocentesis group (0% versus 34%, p < 0.001). Patients undergoing pericardial window had higher odds of major bleeding requiring transfusions. Conclusion: There is a higher rate of recurrence following isolated pericardiocentesis but a comparable mortality difference between the two procedures. Complication rates can be reduced by improving surgical technique and peri-operative management. Meticulous surgical care, infection precautions, and good glycemic control in this immunocompromised subset can preserve the pericardial window as a better management option. Relevance to Patients: Pericardial window is a promising and effective management option for patients with recurrent malignant pericardial effusion, but it comes at the cost of bleeding and infection. More extensive trials are needed to understand better the long-term outcomes of pericardial window or pericardiocentesis in patients with malignant effusion.

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Lung Adenocarcinoma Presenting as Early Cardiac Tamponade: A Case Report

Chapiolkina,

Saadati,

Guevara-Rodriguez

et al. 2024

Case Rep Oncol

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Introduction: Lung cancer remains the most common cause of cancer death in the USA and worldwide despite continued advances in lung cancer screening and treatment. Pericardial effusion (PerF) has been found in up to 50% of postmortem patients with cancer; lung and breast cancers are the most frequent malignancies. Furthermore, it is a sign of poor outcomes with fewer than 5 months of survival. Nevertheless, PErF with or without tamponade as a presentation of lung cancer is uncommon. Case Presentation: We present a 72-year-old male without medical history who presented with 1 month of cough with white sputum and shortness of breath, progressively worsening, associated with weight loss (20 pounds). Further studies demonstrated early cardiac tamponade secondary to malignancy. Conclusion: Cardiac tamponade can arise secondarily from various etiologies and have different presentations depending on the cause. In general, it is a slowly developing and clinically silent disease process. Therefore, malignant PerFs can rarely present with hemodynamic instability and be the initial manifestation of an underlying malignancy. Our case review presents a rare case of metastatic lung adenocarcinoma manifesting as early symptomatic cardiac tamponade and as an emergency. The results might be life-threatening if this presentation is not recognized and managed appropriately. Clinicians must be aware of such atypical presentations of thoracic malignancies to take action adequately.

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Pericardiocentesis Indications and Complications: A Retrospective Observational Study in a Tertiary Care Hospital in Karachi, Pakistan

Cited by 3 publications

References 12 publications

Ultrasound during Advanced Life Support—Help or Harm?

Ultrasound during Advanced Life Support—Help or Harm?

Best management of patients with malignant pericardial effusion: a comparative study between imaging-guided pericardiocentesis and surgical pericardial window

Lung Adenocarcinoma Presenting as Early Cardiac Tamponade: A Case Report

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