Key result
Intrapericardial triamcinolone resolved chronic postoperative pericardial effusion in 3 out of 4 pediatric patients, but all patients developed significant systemic side effects.
Why the study?
Intrapericardial triamcinolone can be used to treat chronic pericardial effusion in adults, but pediatric data are lacking.
Does intrapericardial triamcinolone improve chronic post-surgical pericardial effusion in pediatric patients?
Case Report (n=4)
No
Does intrapericardial triamcinolone improve chronic post-surgical pericardial effusion in pediatric patients?
Intrapericardial triamcinolone is effective for chronic pediatric post-surgical pericardial effusion but causes severe, prolonged systemic side effects and adrenal insufficiency, necessitating close endocrinological monitoring.
May warrant use in refractory cases with endocrinologic monitoring; leaves open safety and efficacy in larger pediatric cohorts.
Intrapericardial triamcinolone can be used to treat chronic pericardial effusion (PE) in adults; however, pediatric data are lacking. In this case series we aim to evaluate the efficacy, safety, and side effects of intrapericardial triamcinolone in children with PE. The incidence and treatment of post-surgical PE from 2009 to 2019 were determined using the institutional surgical database and electronic patient records. Furthermore, a retrospective analysis of efficacy, safety, and side effects of intrapericardial triamcinolone treatment for chronic post-surgical PE was performed. The incidence of postoperative PE requiring treatment was highest after atrial septal defect (ASD) closure when compared to other types of cardiac surgery (9.7% vs 4.3%). Intrapericardial treatment with triamcinolone resolved pericardial effusion in 3 out of 4 patients. All patients developed significant systemic side effects. Surgical ASD closure is associated with an increased risk of development of PE requiring treatment. Intrapericardial triamcinolone is an effective treatment for chronic postoperative PE in children, but is always associated with significant systemic side effects. Close monitoring and treatment of adrenal insufficiency are mandatory in these cases.
No takes yet. Share an insight, caveat, or question.
Werff et al. (2021) conducted a case report in Post-surgical pericardial effusion (n=4). Intrapericardial triamcinolone was evaluated on Resolution of pericardial effusion without recurrence. Intrapericardial triamcinolone resolved chronic postoperative pericardial effusion in 3 out of 4 pediatric patients, but all patients developed significant systemic side effects.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: