Ultrasound Guided Pericardiocentesis
1TBD, Hospital Raja Permaisuri Bainun Ipoh Perak, Malaysia
Cardiac tamponade represents a life-threatening complication of pericardial effusion where prompt recognition and treatment are essential for a favorable outcome . Echocardiography-guided pericardiocentesis is the current technique of choice, which has the highest rate of procedural success and the lowest rate of major compli- cations compared with blind or surgical methods
Several methods have been described to date (para- sternal, apical, or subxiphoid), but the best approach for draining pericardial effusion is controversial as the pro- cedure selection often depends on the patient’s char- acteristics and local hospital expertise . The common techniques use low-frequency probes guiding the needle insertion to where the largest fluid collection is observed and how the needle trajectory avoids vital structures .The parasternal in-plane and real-time technique has only been described anecdotally.
We presented a novel in-plane parasternal medial-to-lateral approach using a high-frequency probe would provide additional benefits in terms of feasibility and safety with a real-time procedure monitoring and avoiding liver, internal thoracic vessels, and lung [2,3]. Here, we have described our preliminary experience using this novel approach in the emergency and critical care setting of tamponade and the technical details.