Cardiac Tamponade Treatment-Reply

Thomas J. Fuller, MD
Arch Intern Med. 1977;137(4):543. doi:10.1001/archinte.1977.03630160098027.
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In Reply.—  The technique for insertion of an indwelling intrapericardial catheter into large nonuremic pericardial effusions followed by prolonged drainage for up to seven days was first reported by Massumi et al in 1968.1 Using a similar technique, prolonged drainage for up to 26 days has also been reported in uremic patients.2,3 To this data, Dr Calescibetta adds his group of 12 patients who required seven days of pericardial drainage. One of the disadvantages of this latter technique appears to be the extended length of pericardial drainage. This theoretically has to be associated with an increased risk of infection. Second, as Dr Calescibetta points out, is the possibility of recurrent tamponade, even with the catheter in place. Also, two of his patients required steroids in addition to prolonged drainage.Buselmeier et al4 and Fuller et al5 added a nonabsorbable steroid to the drainage procedure. This had


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