Key result
Pericardial fluid withdrawal lowers intracardiac pressures, though underlying constriction can keep them elevated.
Why the study?
This study was conducted to describe the haemodynamic events before, during, and after gradual withdrawal of pericardial fluid in patients with moderate pericardial effusion.
Does gradual withdrawal of pericardial fluid with simultaneous pressure recording improve haemodynamic parameters and distinguish between pure effusion and effusive-constrictive disease in patients with moderate pericardial effusion?
Observational (n=5)
Does gradual withdrawal of pericardial fluid with simultaneous pressure recording improve haemodynamic parameters and distinguish between pure effusion and effusive-constrictive disease in patients with moderate pericardial effusion?
Simultaneous recording of intrapericardial and intracardial pressures during pericardiocentesis helps distinguish isolated pericardial effusion from effusive-constrictive pericardial disease.
Answers are grounded in this paper and cite their sources.
Initial aspiration in moderate effusion may rapidly alter hemodynamics, warranting procedural caution; leaves open need for larger studies on optimal drainage.
The study describes the haemodynamic events in five patients with moderate pericardial effusion before, during and after gradual withdrawal of the pericardial fluid. The most marked changes occurred in all cases after the first portion had been aspirated. In general this resulted in an increase in stroke volume and arterial blood pressure although with great individual variations. The intrapericardial, right atrial and left ventricular enddiastolic pressures decreased in all patients. In two cases with constrictive components these latter two pressures, however, remained at a pathologically elevated level at the end of the investigation. In the other cases there was an almost parallel fall in pericardial pressure and in diastolic intracardial pressure in the right as well as the left heart. The described method with simultaneous recording of intrapericardial and intracardial pressure can be used to distinguish between two types of pericardial disease at an early stage of the investigation. One type is characterized by fluid effusion only, while the other has the effusion superimposed upon more pronounced anatomical changes of the visceral layer of the pericardium and possibly also of the myocardium.
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Olsson et al. (1973) conducted an observational in Moderate pericardial effusion (n=5). Gradual withdrawal of pericardial fluid with simultaneous recording of intrapericardial and intracardial pressures was evaluated on Haemodynamic events (stroke volume, arterial blood pressure, intrapericardial, right atrial, and left ventricular end-diastolic pressures).
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