Pericardiocentesis in children: 20-year experience at a tertiary children’s hospital
| Autor: | Daisuke Kobayashi, Thomas J Forbes, Christopher Herron |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Percutaneous medicine.medical_treatment 030204 cardiovascular system & hematology Hemopericardium Pericardial effusion Pericardial Effusion Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine medicine Humans 030212 general & internal medicine Child Adverse effect Retrospective Studies business.industry Pericardial fluid Pericardiocentesis Retrospective cohort study General Medicine medicine.disease Surgery Pediatrics Perinatology and Child Health Etiology Drainage Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiology in the Young. 32:606-611 |
| ISSN: | 1467-1107 1047-9511 |
| DOI: | 10.1017/s104795112100278x |
| Popis: | Background:Pericardiocentesis is the invasive percutaneous procedure for acute and chronic excessive accumulation of pericardial fluid. There is a paucity of data on the effectiveness and safety of pericardiocentesis in children.Objectives:To evaluate the effectiveness and safety of pericardiocentesis and factors associated with acute procedural failure and adverse events.Methods:This was a single-centered retrospective study to describe all the children aged ≤20 years who underwent pericardiocentesis. Data on demographics, etiologies of pericardial effusion, and repeat intervention at follow-up were collected.Results:A total of 127 patients underwent 153 pericardiocentesis. The median age was 6.5 years (1 day–20 years) with weight of 17 kg (0.5–125). Most common etiology was post-pericardiotomy syndrome (n = 56, 44%), followed by infectious (12%), malignant (10%), and iatrogenic (9%). Pericardiocentesis was performed more commonly in the catheterisation laboratory (n = 86, 59%). Concurrent pericardial drain placement was performed in 67 patients (53%). Acute procedural success was 92% (141/153). Repeat intervention was performed in 33 patients (22%). The incidence of adverse events was 4.6% (7/153): hemopericardium requiring emergent surgery (n = 2); hemopericardium with hypotension (n = 2); seizure with anesthesia induction (n = 1); and right ventricle puncture with needle (n = 2). Pericardiocentesis at the bedside had a higher rate of acute procedural failure than that in the catheterisation lab (17 versus 1%, p < 0.01). No identifiable risk factors were associated with adverse events.Conclusions:Pericardiocentesis was life-saving in children with its high effectiveness and safety even in urgent situations. Although initial pericardiocentesis was effective, one of five patients required re-intervention for recurrent pericardial effusion. |
| Databáze: | OpenAIRE |
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