THERAPEUTIC PROCEDURES FOR HEART DISEASES .
PERICARDIOCENTESIS .
Pericardiocentesis is the will pericardial fluid space around the heart. This article describes the benchmark for the blind or syringe and needle technique is used as a measure of relief for the rapid treatment of cardiac tamponade.
Pericardial space normally contains 15-50 ml of fluid acts as a lubricant between the visceral and parietal layers of pericardium. Several systemic conditions may cause a greater amount of fluid in this space. Blood also can collect in this space after trauma.
The clinical manifestations are highly dependent on the size and rate of accumulation of fluid or blood. The worst outcome is the collapse of the ventricle creates a strong decrease in cardiac output, hypotension and cardiac arrest possible.
Echocardiography provides the use of emergency medical beds to rapidly assess the pericardium and identify the presence of a pericardial effusion. Identification of a pericardial effusion causing the collapse of the right ventricle is the diagnosis of pericardial tamponade and pericardiocentesis mandates immediately.
PERICARDIOCENTESIS .
Pericardiocentesis is the will pericardial fluid space around the heart. This article describes the benchmark for the blind or syringe and needle technique is used as a measure of relief for the rapid treatment of cardiac tamponade.
Pericardial space normally contains 15-50 ml of fluid acts as a lubricant between the visceral and parietal layers of pericardium. Several systemic conditions may cause a greater amount of fluid in this space. Blood also can collect in this space after trauma.
The clinical manifestations are highly dependent on the size and rate of accumulation of fluid or blood. The worst outcome is the collapse of the ventricle creates a strong decrease in cardiac output, hypotension and cardiac arrest possible.
Echocardiography provides the use of emergency medical beds to rapidly assess the pericardium and identify the presence of a pericardial effusion. Identification of a pericardial effusion causing the collapse of the right ventricle is the diagnosis of pericardial tamponade and pericardiocentesis mandates immediately.
THERAPEUTIC INDICATIONS .
The signs are cardiac tamponade, and the need to analyze the fluid that surrounds the heart. cardiac tamponade is a condition in which an accumulation of fluid within the pericardium creates excessive pressure, which then prevents the normal filling of the heart blood. This can be crucial to reducing the amount of blood being pumped to the heart, which can be life threatening. Withdrawal of excess liquid to turn this dangerous process. Examples of liquid analysis would be needed to distinguish whether a pericardial fluid collection due to the spread of infection in cancer, or perhaps an autoimmune condition.
CONTRAINDICATIONS .
In hemodynamically unstable patients, the information, the problems are not the type to make a puncture. The withdrawal of a small amount of pericardial fluid can have a dramatic improvement in the patient's hemodynamic status. Contra-indications: bleeding disorders not corrected.
EVALUATION BEFORE PROCEDURE .
Preoperative transthoracic echocardiographic examination should always be done to limit the scope and location of the fluid. At least 1 cm of liquid flowing freely should be achieved by anterior approach. Chest radiography may be useful to demonstrate changes in the mediastinum, pleural effusions, the position of the diaphragm and the size of pericardial shadow.
Any anatomical abnormality should be carefully observed. Patients with cancer may have undergone surgery and radiotherapy before and after these procedures can move or distort normal anatomical location of the structures.
Patients with lung cancer who underwent resection of a lobe may be a change in the anatomical structures. An enlarged left liver lobe extends beyond the midline may be in the path of a needle pericarial xiphoid to the risk of laceration of the liver. abdominal bloating due to a cause can also change the location of vital structures. If there is concern about the anatomy of the patient, the procedure should be performed with echocardiographic guidance.
PROCEDURE.
Previously, this procedure was cardiac catheterization laboratory, but is now usually performed the procedure room, intensive care unit, or even a nightstand. If the line IV fluids or medications must be given. Medication can be given to prevent vasovagal reflex causes bradycardia (slow heart rate) and hypotension (drop in blood pressure). Increase your site under the sternum (breastbone) is cleaned and local anesthetic is given. pericardiocentesis needle inserted later, are always the pericardium. Electrocardiogram (ECG) leads may be connected to the needle clip to help the correct positioning of the needle. However, ultrasound is often used to position the needle and monitor drainage.
Once the needle reached the pericardium, a guide wire inserted. The needle is removed and replaced by a catheter. This fluid is withdrawn and a catheter placed in containers. Usually this pericardial catheter is the place to continue draining for several hours. Surgical pericardiocentesis may be necessary in severe cases. In this procedure, the liquid is drained through a more invasive procedure, which may require anesthesia.
COMPLICATIONS .
Major complications and skin fluoroscopy guided pericardiocentesis achieved through a catheter after surgery, reviewed and holes surgery.Namely non-cardiac, cardiac arrhythmias, arterial bleeding, pneumothorax, especially for children infected and a major vagal reaction. Pericardiocentesis guided by fluoroscopy approach subxiphoid placement of the catheter is a safe way to get the drainage and surgical and nonsurgical pericardial effusions. accidental perforation of the heart with a needle is a small complication, until the needle goes to the front line of the diaphragm and the right ventricle is made reliable drainage catheter.
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