Τίτλος:
Hemorrhagic cardiac tamponade in critically ill patients with acute
renal failure
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
PURPOSE: The purpose of this study was to report the development,
management, and follow up of tamponading uremic pericardial effusion in
critically ill patients with acute renal failure.
SETTING: The setting for this study was an adult, 24-bed tertiary
multidisciplinary intensive care unit (ICU) of a university hospital.
PATIENTS: The subjects were 5 critically ill patients with multiple
organ failure including acute renal failure (ARF) that was slow to
resolve.
RESULTS: Renal involvement was attributed to renal hypoperfusion, sepsis
and myoglobinuria. Continuous veno-venous hemofiltration (CVVH) was
instituted early during hospitalization in 4 cases and lasted for 35 to
48 days; renal replacement therapy was not used in 1 case. Tamponade
developed late in the course of ARF, after CVVH was discontinued in the
4 cases and was effectively managed with percutaneous pericardiocentesis
under echocardiography and continuous catheter drainage of the
pericardial sac for 48 to 72 hours. Hemorrhagic fluid (Hb 2.2-5.9 g/dL)
with lymphocyte predominance was detected. Transient constrictive-like
pericarditis findings were present in all patients after the procedure.
All patients were discharged from the hospital in a good condition with
normal serum and creatinine levels; 1-year follow up showed a normal
echocardiogram.
CONCLUSION: Awareness for the possibility of hemorrhagic pericarditis
and cardiac tamponade is needed in ICU patients with ARF slow to
resolve. Transient constrictive-like pericarditis may present after
pericardiocentesis.
Συγγραφείς:
Zakynthinos, E
Theodorakopoutou, M
Daniil, Z
Konstantinidis,
K
Zakynthinos, S
Περιοδικό:
Heart, Lung and Circulation
Εκδότης:
Mosby Year Book Inc
DOI:
10.1016/j.hrtlng.2003.10.008
