Emergency department pericardial drainage for penetrating cardiac wounds is a viable option for stabilization

Teresa S. Jones, Clay Cothren Burlew, Robert T. Stovall, Fredric M. Pieracci, Jeffrey L. Johnson, Gregory Jurkovich, Ernest E. Moore

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

BACKGROUND: Penetrating cardiac injuries (PCI) causing tamponade causes subendocardial ischemia, arrhythmias, and cardiac arrest. Pericardial drainage is an important principle, but where drainage should be performed is debated. We hypothesize that drainage in the emergency department (ED) does not delay definitive repair. METHODS: Over a 16-year period, patients sustaining PCI were reviewed. RESULTS: Seventy-eight patients with PCI survived to the operating room (OR), with 39 undergoing ED thoracotomy. An additional 39 patients underwent pericardial drainage, 17 (44%) in the ED and 22 in the OR. Comparing the ED with OR pericardial drainage groups, they had a similar ED systolic pressure (99 ± 25 vs 99 ± 34), heart rate (103 ± 16 vs 85 ± 37), median time to the OR (20 vs 22 min), and mortality (12% vs 23%). CONCLUSIONS: ED pericardial drainage for PCI did not appear to delay operation and had an acceptably low mortality rate. Pericardial drainage is a viable option for stabilization before definitive surgery when surgical intervention is not immediately available in the hemodynamically marginal patient.

Original languageEnglish (US)
Pages (from-to)931-934
Number of pages4
JournalAmerican Journal of Surgery
Volume207
Issue number6
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Keywords

  • Cardiac injury
  • ED thoracotomy
  • Penetrating trauma
  • Pericardial drain
  • Pericardial tamponade
  • Trauma

ASJC Scopus subject areas

  • Surgery

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