Hemopericardium After Cardiopulmonary Resuscitation—Bedside Drainage with a Triple-Lumen Catheter: A Case Report

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Hemopericardium and cardiac tamponade following cardiopulmonary resuscitation (n=1). Intervention: Ultrasound-guided pericardiocentesis using a 7-French triple-lumen central venous catheter. Primary outcome: Pericardial fluid drainage and resolution of cardiac tamponade.

Q: What does this research mean for the field?

A triple-lumen central venous catheter can serve as an effective bedside alternative for acute pericardial drainage and tamponade relief following cardiopulmonary resuscitation when commercial pericardiocentesis kits are unavailable. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Michael Gagliardi; Melissa Luu; Rose-Ann Weick; Rebecca White; Mohammad T. Abboud

doi:10.5811/cpcem.63687

October 13, 2026Clinical Practice and Cases in Emergency MedicineOpen Access

Hemopericardium After Cardiopulmonary Resuscitation—Bedside Drainage with a Triple-Lumen Catheter: A Case Report

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Key result

Emergency pericardiocentesis with a triple-lumen central venous catheter successfully resolves tamponade, draining ~1 L.

n=1

Why the study?

Hemopericardium from chest compression-related cardiac injury is an underrecognized complication of cardiopulmonary resuscitation, with bleeding risk amplified in anticoagulated patients.

Key Points

To describe the emergency bedside management of post-resuscitation hemopericardium with a central venous catheter when commercial pericardiocentesis kits are unavailable.
Case report of a 66-year-old man on apixaban and hemodialysis presenting in cardiac arrest who underwent approximately 38 minutes of cumulative chest compressions.
Bedside ultrasound-guided subxiphoid insertion of a seven French triple-lumen central venous catheter for pericardial decompression in the absence of a standard pericardiocentesis kit.
Post-resuscitation ultrasound demonstrated pericardial tamponade following prolonged chest compressions in an anticoagulated patient.
Approximately one liter of bloody pericardial fluid was aspirated through the triple-lumen catheter.
The patient died within 24 hours of presentation.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P

Population

A 66-year-old man with atrial fibrillation on apixaban and end-stage renal disease on hemodialysis who developed cardiac tamponade from hemopericardium after 38 minutes of cardiopulmonary resuscitation, followed for 24 hours until death.

I

Intervention

Bedside pericardiocentesis and continuous pericardial drainage using a 7-French triple-lumen central venous catheter placed over a guidewire via a subxiphoid approach under dynamic ultrasound guidance, connected to a Pleur-Evac on low continuous suction, plus reversal of anticoagulation with andexanet alfa.

O

Outcome

Resolution of pericardial effusion on ultrasound, hemodynamic stabilization, and patient survival at 24 hourshard clinical

This case report highlights CPR-related hemopericardium as a life-threatening complication in anticoagulated patients and demonstrates that a 7-French triple-lumen central venous catheter can serve as an effective emergency bedside pericardial drain when a commercial pericardiocentesis kit is unavailable.

Limitations

Single-patient case report
Uncertain whether hemopericardium preceded the initial cardiac arrest or developed solely as a consequence of prolonged resuscitation
Triple-lumen catheter openings are configured for venous infusion rather than fluid drainage, which may increase the risk of obstruction from fibrin, particulate debris, or clotted blood
Whether hemopericardium preceded the initial cardiac arrest or developed as a consequence of prolonged resuscitation cannot be determined with certainty
The triple-lumen catheter has a single distal-end hole and two staggered side ports configured for venous infusion rather than fluid drainage, which may increase the risk of obstruction from fibrin, particulate debris, or clotted blood

Implication

May offer emergency drainage option when kits unavailable; leaves open need for validation before any clinical adoption.

Abstract

Introduction: Hemopericardium from chest compression-related cardiac injury is an underrecognized complication of cardiopulmonary resuscitation, with bleeding risk amplified in anticoagulated patients. Case Report: A 66-year-old man on apixaban and hemodialysis presented in cardiac arrest. Post resuscitation ultrasound revealed pericardial tamponade. With no pericardiocentesis kit available, a seven French triple-lumen central venous catheter was placed under ultrasound guidance via a subxiphoid approach. Approximately one liter of bloody fluid was drained; the patient died within 24 hours. Conclusion: Hemopericardium is an underrecognized complication of resuscitation in anticoagulated patients. A triple-lumen central venous catheter offers a familiar bedside drainage alternative when a commercial kit is unavailable.

Discussion

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Cite This Study

Gagliardi et al. (2026) conducted a case report in Hemopericardium and cardiac tamponade following cardiopulmonary resuscitation (n=1). Ultrasound-guided pericardiocentesis using a 7-French triple-lumen central venous catheter was evaluated on Pericardial fluid drainage and resolution of cardiac tamponade. Bedside pericardiocentesis with a 7-Fr triple-lumen central venous catheter drained ~1 L of blood and resolved tamponade after CPR in an anticoagulated patient, who died within 24 hours.

synapsesocial.com/papers/6ae28e56cbadf70daf6c4189 https://doi.org/10.5811/cpcem.63687

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Hemopericardium After Cardiopulmonary Resuscitation—Bedside Drainage with a Triple-Lumen Catheter: A Case Report

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Hemopericardium After Cardiopulmonary Resuscitation—Bedside Drainage with a Triple-Lumen Catheter: A Case Report

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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