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. Received: 27 August 1999 Final revision received: 18 January 2000 Accepted: 28 February 2000