Cardiac Tamponade Following Penetrating Mediastinal Injuries: Improved Survival With Early Pericardiocentesis
Document Type
Article
Publication Date
1-1-1979
Description
Cardiac tamponade was diagnosed in 197 patients admitted over 20 years (1955-1974) to the Charity Hospital of New Orleans, for emergency treatment of penetrating mediastinal injuries. Of the 197, 174 definitively treated patients followed one of three patterns of management: 96 had OR thoracotomy, 68% were unstable, and preoperative pericardiocentesis reduced mortality from 25 to 11% (p < 0.01); 44 had emergency thoracotomy, 91% were unstable, and prethoracotomy pericardiocentesis decreased mortality from 94 to 63% (p < 0.05); 34 patients primarily with isolated stab wounds, were treated nonsurgically with pericardiocentesis and observation, only 50% were unstable and there was 15% mortality. Recurrent tamponade did not significantly increase overall or operative mortality in patients with pericardiocentesis. Recommendations: early, even presumptive, diagnosis of tamponade; immediate pericardial decompression via pericardiocentesis; and rapid transfer to OR for thoracotomy or sternotomy and cardiorrhaphy with continous pericardial decompression via intrapericardial catheter.
Citation Information
Breaux, Edgar P.; Dupont, J. Benton; Albert, Harold M.; Bryant, Lester R.; and Schechter, Frederick G.. 1979. Cardiac Tamponade Following Penetrating Mediastinal Injuries: Improved Survival With Early Pericardiocentesis. Journal of Trauma - Injury, Infection and Critical Care. Vol.19(6). 461-466. https://doi.org/10.1097/00005373-197906000-00008 PMID: 448783 ISSN: 0022-5282