Pericardiocentesis: What are its Preparation, Procedure, and Risks?
Pericardiocentesis is a medical procedure that involves the removal of fluid from the pericardial sac. The pericardial sac, or the pericardium, is the one surrounding the heart and the great vessels. Its major role is to protect the heart. It also supplies lubrication by releasing fluid in the pericardial cavity. Having too much amount of fluid in the heart can present risks to the heart. If this is the case, a pericardiocentesis procedure is needed.
Why is pericardiocentesis needed?
A condition characterized by having an excess amount of fluid in the pericardial cavity or around the heart is called pericardial effusion. Pericardial effusion is a serious condition that needs to be treated right away through a pericardiocentesis procedure. If not treated right away, pericardial effusion can create adverse effects to the heart due to the severe amount of pressure brought by the excess fluid. This condition is called a pericardial tamponade.
A pericardiocentesis procedure is done in cases like this to remove the fluid that could destroy the normal functions of the heart. In a pericardiocentesis procedure, the pericardial fluid and the source of the abnormal accumulation is located and examined. Examination of the fluid can be substantial when determining if there is a greater infection or disease that is causing the accumulation of fluid. In summary, pericardiocentesis is done to drain fluid, examine the fluid, and locate the source of build up.
What are the preparations needed before a pericardiocentesis procedure?
Before a patient is brought to the surgical table, they are given orders on how they can prepare for the procedure. A patient needs to make the proper preparations before the pericardiocentesis procedure so that the surgical operation runs smoothly and chances of complications are lessened.
Under normal circumstances, preparatory tests are conducted that can determine the severity of the condition. These tests include chest X-rays, blood tests, electrocardiogram, echocardiograms, and other exams that focus on the area of the pericardial cavity.
During the time when a doctor has the sufficient indications to qualify a patient for a pericardiocentesis procedure, the patient must be informed of the risks that come together during and after the procedure has been carried out. Typically, the doctor will also have to find out if the patient is undergoing other medications. This is very pertinent information for the doctor because there are certain medications that can interfere with the procedure. These medications include, but are not limited to anti-inflammatory medicines and blood thinners. A patient’s intake of these medications needs to be paused at least one week prior to undergoing a pericardiocentesis procedure. The doctor will also have to know of the patient’s medical history to find out about any allergies.
A patient will also be typically ordered to reduce or completely restrict their food and fluid consumption at least six hours before the scheduled time of procedure. The nurse or a doctor shall be able to advise you of the certain foods and fluids that you can only take. These are only some of the preparations needed in order to have a successful procedure. All these preparations shall be able to reduce the risk of complications that may arise during the surgical procedure. These preparations are disregarded in cases when an emergency pericardiocentesis procedure is needed.
How is pericardiocentesis performed?
Before performing the procedure, the patient is required to take a supine position (lying down flat on the back with the head slightly elevated). A supine position is critical in surgical procedures like this because it allows better access to the pericardial region. If the patient assumes the supine position, the needle and the catheter can be easily inserted into position.
It is standard procedure that a patients arm is attached to an IV, if in case there is a need for fluids or medicines to be administered while the procedure is undergoing. An anesthetic is also administered to the patient so that the feelings of pain are reduced.
As the needle is inserted into the pericardial cavity, the doctor is guided with the use of an ultrasound or electrocardiographic device. These devices do not only help the doctor in positioning the needle but it also monitors the amount of fluid that is drained and left in the pericardial cavity.
After the needle is positioned correctly, the doctor replaces it with a catheter. The catheter is a tube wherein the drained fluid shall flow out going to a container. The tube should remain there until all fluid has been drained from the pericardial cavity. Typically, a pericardiocentesis procedure lasts for two minutes to one hour, if the method runs without complications.
What are the results of a pericardiocentesis procedure?
After a successful pericardiocentesis procedure, a patient has to be monitored in order to make sure that no complications arise and recovery is fast for the patient. Normal results of the procedure should show the presence of a clear fluid in the pericardial cavity.
In other cases, an examined fluid can show the presence of an underlying condition causing the abnormal accumulation of fluid. Medical conditions that can cause the fluid buildup could include cancer, cardiac perforation, cardiac trauma, congestive heart failure, or ventricular aneurysm.
What are the risks of a pericardiocentesis procedure?
In rare circumstances when a procedure does not succeed right away, there are certain complications that can arise. A patient is under the risk of suffering from bleeding, lung collapse, heart attack or irregular heartbeat, severe perforation or pneumopericardium where air has entered the pericardial cavity.
But in most cases, a procedure like this often ends successfully. Because the procedure does not take too long, the time that a patient is exposed to risks is also lessened.
What are the indications that this procedure is needed?
A doctor will determine if this procedure is needed if the patient is suffering from pericardial effusion or pericardial tamponade. These are very life-threatening conditions that can take the life of a person at any minute. These conditions bring a lot of pressure to the heart thus preventing it from supplying the sufficient amount of blood oxygen that the body needs. A patient’s life can be saved from these conditions by undergoing a right way procedure of pericardiocentesis.
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