Pericardiocenteses: 7 Anos de Experiência

Introduction: Pericardiocentesis is a valuable technique to diagnose and treat patients with pericardial effusion, and several methods have already been tested to reduce complication and increase success rates of this procedure. The aim of this study was to evaluate procedure success, use of echocardiogram, complications rate and usefulness for etiologic study of patients with pericardial effusion. Material and Methods: Retrospective analysis of 55 pericardiocentesesis performed on 48 patients between January 2013 and December 2019 in an Intensive Care Unit from a peripheral hospital. Results and Discussion: It was assisted by echocardiography in 64% of cases, with a 100% success rate, 9.1% complications rate, and 12.7% recurrence rate. There was a greater number of punctures necessary for success, a higher rate of complications and greater severity of them when pericardiocenteses was not guided by echocardiography, which explains worse outcomes when compared to other series where echocardiography was used in every single procedure. Pericardial fluid analysis did not allow extrapolating Light criteria for pleural effusion, however there was a tendency for an association between classic exudate cases (neoplasia and infection) and higher LDH in pericardial fluid; ADA>50 U/L was very specific for tuberculous pericardial effusion. Most common etiology was neoplastic (33%, n = 16), with an average survival of 5.7 months in these patients, compared with 21.6 months in other causes. Conclusion: Echocardiogram-guided pericardiocenteses had a high success rate associated with a lower percentage of complications, which is why its use in all procedures is advocated. This technique has a main therapeutic goal in moderate to severe effusions, since it was not possible to obtain useful criteria to establish an etiological diagnosis.