Abstract | PURPOSE: METHODS: A retrospective review of patients placed on ECMO at our institution from 1993 to 1997 was performed. The case histories of 4 patients in whom pericardial tamponade developed caused by a serous effusion were reviewed in detail. RESULTS: The first patient presented with hypotension while on venovenous (VV) ECMO. The hypotension improved with fluid resuscitation. The patient was converted from (VV) to venoarterial (VA) ECMO when hypotension recurred. After a third episode of hypotension, a narrow pulse pressure was noted, and echocardiography results confirmed a pericardial effusion. The diagnosis was recognized earlier in the course of the subsequent 3 patients. All 4 patients were treated with aspiration of serous fluid from the pericardium with an over-the-needle plastic catheter that was left in place. More than 1 aspiration was required in all cases. All 4 patients survived. CONCLUSIONS: The authors have identified a group of ECMO patients with pericardial tamponade caused by serous effusion with good response to treatment. A high index of suspicion and early echocardiography is warranted to confirm the diagnosis in a patient with hypotension on ECMO.
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Authors | M S Kurian, E R Reynolds, R A Humes, M D Klein |
Journal | Journal of pediatric surgery
(J Pediatr Surg)
Vol. 34
Issue 9
Pg. 1311-4
(Sep 1999)
ISSN: 0022-3468 [Print] United States |
PMID | 10507418
(Publication Type: Journal Article)
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Topics |
- Cardiac Tamponade
(diagnostic imaging, etiology)
- Extracorporeal Membrane Oxygenation
(adverse effects)
- Female
- Humans
- Infant
- Infant, Newborn
- Male
- Pericardial Effusion
(complications, diagnostic imaging, therapy)
- Pericardiocentesis
- Retrospective Studies
- Ultrasonography
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