Abstract
Background
Penetrating cardiac injuries (PCI) causing tamponade causes subendocardial ischemia,
arrhythmias, and cardiac arrest. Pericardial drainage is an important principle, but
where drainage should be performed is debated. We hypothesize that drainage in the
emergency department (ED) does not delay definitive repair.
Methods
Over a 16-year period, patients sustaining PCI were reviewed.
Results
Seventy-eight patients with PCI survived to the operating room (OR), with 39 undergoing
ED thoracotomy. An additional 39 patients underwent pericardial drainage, 17 (44%)
in the ED and 22 in the OR. Comparing the ED with OR pericardial drainage groups,
they had a similar ED systolic pressure (99 ± 25 vs 99 ± 34), heart rate (103 ± 16
vs 85 ± 37), median time to the OR (20 vs 22 min), and mortality (12% vs 23%).
Conclusions
ED pericardial drainage for PCI did not appear to delay operation and had an acceptably
low mortality rate. Pericardial drainage is a viable option for stabilization before
definitive surgery when surgical intervention is not immediately available in the
hemodynamically marginal patient.
Keywords
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Article info
Publication history
Published online: January 06, 2014
Received in revised form:
August 27,
2013
Received:
May 22,
2013
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
