Key result
Echocardiography-guided percutaneous pericardiocentesis and pigtail catheter placement safely treated purulent pericardial effusion in children, with 13 of 22 patients requiring drainage and only one needing subsequent pericardiectomy.
Why the study?
Purulent pericarditis can cause significant morbidity and mortality if not managed timely, but guidelines for managing purulent pericardial effusion in pediatric patients are lacking.
Observational (n=22)
No
Echocardiography-guided percutaneous pericardiocentesis and pigtail catheter placement are safe and effective treatments for purulent pericardial effusion in children.
Supports percutaneous drainage in pediatric purulent pericarditis; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: Purulent pericarditis, if not recognized and managed timely, it can lead to significant morbidity and mortality. There are no guidelines for the management of purulent pericardial effusion in pediatric patients. AIM: The study describes our experience with the management of 22 patients admitted with a primary diagnosis of purulent pericardial effusion seen over a 7-year period. MATERIALS AND METHODS: Hospital records of 22 children admitted to the pediatric intensive care unit with purulent pericardial effusion during January 2012-December 2018 were retrospectively analyzed. RESULTS: was the most commonly isolated organism. Out of 22, pericardial drainage was done in 13 patients (59%). Only one of these patients required pericardiectomy later on. Six (27.2%) patients responded to antibiotics alone. Three (13.6%) patients died before any intervention could be planned. CONCLUSION: Echocardiography-guided percutaneous pericardiocentesis and pigtail catheter placement are a safe and effective treatment for purulent pericardial effusion. When pericardial drainage is not amenable, close monitoring of the size of effusion by serial echocardiography is required. Small residual pericardial effusion may be managed conservatively.
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Agrawal et al. (2020) conducted an observational in Purulent pericardial effusion (n=22). Echocardiography-guided percutaneous pericardiocentesis and pigtail catheter placement vs. Medical management alone was evaluated on Duration of hospital stay, mortality, development of constrictive pericarditis, and recurrence of effusion. Echocardiography-guided percutaneous pericardiocentesis and pigtail catheter placement safely treated purulent pericardial effusion in children, with 13 of 22 patients requiring drainage and only one needing subsequent pericardiectomy.
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