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.