Key result
Direct pericardial blood reinfusion triggers fatal ARDS and disseminated intravascular coagulation after cardiac tamponade.
Why the study?
Direct reinfusion of pericardial blood triggers a systemic inflammatory response, but the role of damage-associated molecular patterns remains poorly understood, and the practice is still sometimes used in emergencies despite contrary guidelines.
Case Report (n=1)
No
Direct reinfusion of pericardial blood can precipitate severe and fatal systemic inflammatory responses, likely mediated by DAMPs such as HMGB-1, and should be avoided even in emergency settings.
Direct reinfusion of pericardial blood may trigger fatal ARDS and DIC; this case supports consensus against the practice but remains hypothesis-generating.
Background: Direct reinfusion of pericardial blood during cardiac surgery triggers a systemic inflammatory response. Although various inflammatory mediators have been identified as triggers, the role of damage-associated molecular patterns (DAMPs) remains poorly understood. Despite guidelines recommending against this practice owing to its harmful effects, it is sometimes used in emergencies. Case Presentation: A 72-year-old man with atrial fibrillation and cerebral infarction developed cardiac tamponade during catheter ablation. He underwent pericardial drainage and direct blood reinfusion. He was transferred to our ICU, where he developed acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC). Despite aggressive management, the patient died 41 days after admission. Conclusion: This case highlights severe adverse events following direct reinfusion of pericardial blood. These findings suggest a significant role for DAMPs in mediating these inflammatory responses. Direct reinfusion of pericardial drainage blood should be avoided during emergencies to prevent life-threatening complications.
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Yasuda et al. (2024) conducted a case report in Cardiac tamponade (n=1). Direct reinfusion of pericardial drainage blood was evaluated on Development of acute respiratory distress syndrome and disseminated intravascular coagulation. Direct reinfusion of pericardial blood after cardiac tamponade resulted in severe acute respiratory distress syndrome, disseminated intravascular coagulation, and death at 41 days.
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