Virginia Zarama, Carlos E Vesga, John Balanta-Silva, Mario M Barbosa, Jaime A Quintero, Ana Clarete, Paula A Vesga-Reyes, Juan Carlos Silva Godinez
{"title":"Complication rates in real-time ultrasound-guided vs static echocardiography-guided pericardiocentesis: a cohort study.","authors":"Virginia Zarama, Carlos E Vesga, John Balanta-Silva, Mario M Barbosa, Jaime A Quintero, Ana Clarete, Paula A Vesga-Reyes, Juan Carlos Silva Godinez","doi":"10.1186/s44156-025-00071-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Static echocardiography-guided pericardiocentesis, the current standard of care, uses a phased-array probe to locate the largest fluid pocket, marking the safest entry site and needle trajectory. Nevertheless, real-time needle visualization throughout the procedure would potentially increase success and decrease complications. The aim of this study was to assess the complication rates of the real-time in-plane ultrasound-guided technique compared to the traditional static echocardiography-guided pericardiocentesis.</p><p><strong>Methods: </strong>All adult patients who underwent pericardiocentesis in a tertiary care hospital from January 2011 to June 2024 were identified. The incidence of total complications of the real-time, in-plane, US-guided pericardiocentesis versus the static echocardiography-guided technique was compared using a regression model with overlap weighting, based on propensity scores, to adjust for confounding factors.</p><p><strong>Results: </strong>A total of 220 pericardiocentesis were identified, 91 with real-time, in-plane US-guided technique and 129 with a static echo-guided approach. The overall rate of total complications was 5.5%, with no significant difference between both techniques (IRR 1.06 [95% CI 0.98 to 1.16, p = 0.163]). Only one major complication was reported with the in-plane technique (pulmonary edema) compared to four major complications in the echo-assisted approach (three cardiac injuries and one injury to thoracic vessels), all of which required emergency surgery. The success rate was higher in the real-time in-plane US-guided procedures (97%) compared to the static echo-guided approach (93%).</p><p><strong>Conclusions: </strong>In this single-center retrospective cohort study, real-time in-plane, US-guided pericardiocentesis technique was safe, and the rate of total complications was not significantly different from a static echo-guided approach. The low rate of major complications and high success rate underscores the potential use of this technique in emergency situations by well-trained physicians. Future studies are warranted to thoroughly assess the potential benefits of the real-time approach.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"8"},"PeriodicalIF":3.2000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959931/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Echo Research and Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s44156-025-00071-6","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Static echocardiography-guided pericardiocentesis, the current standard of care, uses a phased-array probe to locate the largest fluid pocket, marking the safest entry site and needle trajectory. Nevertheless, real-time needle visualization throughout the procedure would potentially increase success and decrease complications. The aim of this study was to assess the complication rates of the real-time in-plane ultrasound-guided technique compared to the traditional static echocardiography-guided pericardiocentesis.
Methods: All adult patients who underwent pericardiocentesis in a tertiary care hospital from January 2011 to June 2024 were identified. The incidence of total complications of the real-time, in-plane, US-guided pericardiocentesis versus the static echocardiography-guided technique was compared using a regression model with overlap weighting, based on propensity scores, to adjust for confounding factors.
Results: A total of 220 pericardiocentesis were identified, 91 with real-time, in-plane US-guided technique and 129 with a static echo-guided approach. The overall rate of total complications was 5.5%, with no significant difference between both techniques (IRR 1.06 [95% CI 0.98 to 1.16, p = 0.163]). Only one major complication was reported with the in-plane technique (pulmonary edema) compared to four major complications in the echo-assisted approach (three cardiac injuries and one injury to thoracic vessels), all of which required emergency surgery. The success rate was higher in the real-time in-plane US-guided procedures (97%) compared to the static echo-guided approach (93%).
Conclusions: In this single-center retrospective cohort study, real-time in-plane, US-guided pericardiocentesis technique was safe, and the rate of total complications was not significantly different from a static echo-guided approach. The low rate of major complications and high success rate underscores the potential use of this technique in emergency situations by well-trained physicians. Future studies are warranted to thoroughly assess the potential benefits of the real-time approach.
期刊介绍：
Echo Research and Practice aims to be the premier international journal for physicians, sonographers, nurses and other allied health professionals practising echocardiography and other cardiac imaging modalities. This open-access journal publishes quality clinical and basic research, reviews, videos, education materials and selected high-interest case reports and videos across all echocardiography modalities and disciplines, including paediatrics, anaesthetics, general practice, acute medicine and intensive care. Multi-modality studies primarily featuring the use of cardiac ultrasound in clinical practice, in association with Cardiac Computed Tomography, Cardiovascular Magnetic Resonance or Nuclear Cardiology are of interest. Topics include, but are not limited to: 2D echocardiography 3D echocardiography Comparative imaging techniques – CCT, CMR and Nuclear Cardiology Congenital heart disease, including foetal echocardiography Contrast echocardiography Critical care echocardiography Deformation imaging Doppler echocardiography Interventional echocardiography Intracardiac echocardiography Intraoperative echocardiography Prosthetic valves Stress echocardiography Technical innovations Transoesophageal echocardiography Valve disease.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
