The Usefulness of Diagnostic Tests on Pericardial Fluid

Meyers, David G.; Meyers, Rayma E.; Prendergast, Thomas

doi:10.1378/chest.111.5.1213

Cited by 131 publications

(100 citation statements)

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“…The complication rate in our cohort (36.1%) was higher than rates previously reported (between 5% and 32% for the various procedures), mainly attributable to minor complications such as atrial arrhythmias, which might have been underreported in other studies. In our study, the diagnostic yield from pericardiocentesis (92.9%) was similar to the expected yield, which was 92% in a larger series including 165 patients 15 . The diagnostic value of pericardiotomy is less well described in the literature, but was reported to be 53% in a recent retrospective comparison, with no difference when compared with pericardiocentesis (44%) 12 .…”

Section: Discussionsupporting

confidence: 86%

Pericardiocentesis versus Pericardiotomy for Malignant Pericardial Effusion: A Retrospective Comparison

2015

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Section: Discussionsupporting

confidence: 86%

Pericardiocentesis versus Pericardiotomy for Malignant Pericardial Effusion: A Retrospective Comparison

2015

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“…Cytologic analysis of pericardial effusion does not appear to be highly sensitive for achieving a diagnosis with primary cardiac neoplasms in people. However, it appears to have a moderate to high sensitivity for metastatic neoplasia (61–100%) and specificity for metastatic neoplasia in human patients (93.3–100%) 18, 20. This variable diagnostic yield in human patients is explained by the differences in the underlying etiology of pericardial neoplasia.…”

Section: Discussionmentioning

confidence: 99%

“…Similar to veterinary medicine, the diagnostic utility of cytologic analysis of pericardial effusion in human medicine is variable; overall the diagnostic utility is between 24 and 26% 15, 16. Although, with malignant neoplastic effusions, the sensitivity is between 67 and 92% and identifying neoplastic cells in pericardial effusion is considered to be an accurate method to distinguish malignant from benign pericardial effusions 17, 18, 19, 20, 21. Diagnostic yield of pericardial effusion analysis is improved with a combination of cytology as well as pericardial and epicardial biopsy via pericardioscopy 22…”

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confidence: 99%

Diagnostic Yield of Cytologic Analysis of Pericardial Effusion in Dogs

Cagle

Epstein

Owens

et al. 2013

Veterinary Internal Medicne

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BackgroundPericardial effusion cytology is believed by many to be of limited value, yet few studies have evaluated its diagnostic utility.ObjectivesTo determine the diagnostic utility of cytologic analysis of pericardial effusion in dogs and to determine if consideration of additional data could improve the diagnostic yield.AnimalsTwo hundred and fifty‐nine dogs with cytologic analysis of pericardial effusion performed between April 1990 and June 2012.MethodsElectronic medical records from a university teaching hospital were retrospectively reviewed; signalment, complete blood count, serum biochemistry, cytologic analysis of pericardial effusion, and echocardiographic data were recorded. Cytology was classified as diagnostic (infectious or neoplastic) or nondiagnostic (hemorrhagic or other) and groups were compared with multiple Student's t‐tests.ResultsCytology was grouped as nondiagnostic (92.3%) or diagnostic (7.7%) and characterized as hemorrhagic (90%), neoplastic (4.6%), infectious (3.1%), or other (2.3%). Overall cytologic analysis of pericardial effusion diagnostic utility was 7.7% and increased to 20.3% if the effusion hematocrit (HCT) <10%; echocardiographic evidence of a mass did not result in a significant increase in the diagnostic utility.Conclusions and Clinical ImportanceThe diagnostic utility of cytologic analysis of canine pericardial effusion is variable depending on the underlying etiology. In this group of dogs, the diagnostic yield of cytologic analysis was greater for pericardial effusion samples in which the HCT was less than 10%.

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“…An exudate is defined as one or more of the following: fluid protein/serum protein ratio>0.5; Fluid LDH/Serum LDH ratio>0.6 and/or fluid LDH levels>200 IU/L [18] . These criteria can be extrapolated to pericardial fluid as well and are the most reliable tools for identifying pericardial exudates [16,19] .…”

Section: Discussionmentioning

confidence: 99%