Pericardiocentesis: differential aspects of a common procedure.

OBJECTIVE

To evaluate the risk and effectiveness of pericardiocentesis in primary and repeat cardiac tamponade.

DESIGN

Retrospective analysis.

SETTING

Intensive care unit in a medical university hospital.

PATIENTS

Sixty-three consecutively admitted patients with cardiac tamponade.

INTERVENTIONS

In all patients pericardiocentesis was performed via the subxiphoid pathway after echocardiographic detection of the pericardial effusion.

MEASUREMENTS AND RESULTS

There was no adverse event in patients undergoing primary pericardiocentesis, which was sufficient to resolve pericardial effusion in 51 of 63 patients (81%). However, repeat pericardiocentesis necessitated by the recurrence of symptomatic pericardial effusion yielded suboptimal results in 10 of 12 patients (83%).

CONCLUSION

Pericardiocentesis is the treatment of choice for primary symptomatic pericardial effusion. In recurrent pericardial effusion surgical approaches appear to be preferable.