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5.2.7 - Needle Pericardiocentesis in Intensive Care

from Section 5.2 - Practical Cardiovascular System

Published online by Cambridge University Press:  27 July 2023

By
Peter Remeta
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Cardiac tamponade is a life-threatening condition resulting from compression of the heart by accumulating fluid, blood, clots or pus within the pericardium.

  2. 2. The clinical picture is one of obstructive shock, characterised by equalisation of intra-cardiac pressures.

  3. 3. The amount of fluid required to cause cardiac tamponade varies and depends on the speed of accumulation, compliance of the pericardium and volume of fluid.

  4. 4. In a patient with clinical suspicion of tamponade, echocardiography is recommended as the first imaging technique to assess the size, location and haemodynamic impact of the pericardial effusion.

  5. 5. Cardiac tamponade is an indication for urgent pericardiocentesis or surgery.

Keywords

cardiac tamponadepericardiumpericardiocentesisechocardiography
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 584 - 588
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Adler, Y, Charron, P, Imazio, M, et al. 2015 ESC guidelines for the diagnosis and management of pericardial diseases. Eur Heart J 2015;36:2921–64.CrossRefGoogle ScholarPubMed
Gluer, R, Murdoch, D, Haqqani, HM, Scalia, GM, Walters, DL. Pericardiocentesis – how to do it. Heart Lung Circ 2015;24:621–5.CrossRefGoogle ScholarPubMed
Holmes, DR, Nishimura, R, Fountain, R, Zoltan, G. Iatrogenic pericardial effusion and tamponade in the percutaneous intracardiac intervention era. JACC Cardiovasc Interv 2009;2:705–17.CrossRefGoogle ScholarPubMed
Porter, TR, Shillcutt, SK, Adams, MS, et al. Guidelines for the use of echocardiography as a monitor for therapeutic intervention in adults: a report from the American Society of Echocardiography. J Am Soc Echocardiogr 2015;28:40–56.CrossRefGoogle ScholarPubMed
Tsang, TS, Enriquez-Sarano, M, Freeman, WK, et al. Consecutive 1127 therapeutic echocardiographically guided pericardiocenteses: clinical profile, practice patterns, and outcomes spanning 21 years. Mayo Clinic Proc 2002;77:429–36.CrossRefGoogle Scholar

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