Should pericardial drainage be performed routinely in patients who have a large pericardial effusion without tamponade

摘要: Abstract PURPOSE: To assess whether drainage of pericardial effusion by pericardiocentesis or surgery is justified as a routine measure in the initial management patients with large without tamponade suspected purulent pericarditis. SUBJECTS AND METHODS: All pericarditis who were seen at our institution during span 6 years (1990 to 1995) retrospectively (46) prospectively (25) reviewed. Large was defined sum echo-free spaces diastole exceeding 20 mm. RESULTS: diagnosed 162 patients, 71 whom fulfilled criteria for inclusion. Of these, 26 underwent procedure. Diagnostic yield 7%, only 2 specific diagnoses made using these procedures. During follow-up (95% median 10 months), no patient developed cardiac died result disease, nor did any new become manifest 45 not have initially. Moderate effusions persisted managed conservatively. CONCLUSIONS: Routine procedures very low diagnostic pericarditis, and clear therapeutic benefit obtained this approach. Clinical outcomes depend on underlying diseases, do appear be influenced fluid.