Pericardial catheter placement versus needle pericardiocentesis in the management of canine pericardial effusion: a pilot randomized trial

Cook, Simon (2020) Pericardial catheter placement versus needle pericardiocentesis in the management of canine pericardial effusion: a pilot randomized trial. Journal of Veterinary Emergency and Critical Care. (In Press)

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Abstract

Objective To compare the safety and efficacy of pericardial catheter placement with needle pericardiocentesis in dogs with pericardial effusion (PE) Design Prospective, pilot randomized trial. Setting University teaching hospital. Animals Thirty client-owned dogs requiring pericardiocentesis prospectively recruited between January 2017 and August 2019. Interventions Dogs were randomized to undergo PE drainage via indwelling pericardial catheter placement (catheter group) followed by elective drainage every 4-6 hours or needle pericardiocentesis (needle group) repeated as necessary. Measurements and main results 15 dogs were allocated to the catheter group and 15 to the needle group. Data collected included signalment, cause of effusion, occurrence of arrhythmias pre-, during and post pericardiocentesis, procedural length and details of repeated drainages. There was no significant difference between mean procedural times for pericardial catheter placement (17.7 minutes (±11.8)) and needle pericardiocentesis (12.1 minutes (±8.6)) (p = 0.192) or the rate of new arrhythmias in the catheter (36%) and needle (64%) groups (p=0.24). Pericardial catheters were kept in situ for a median of 21 hours (range 14-85). 3/15 (20%) dogs in the needle group required repeated pericardiocentesis within 24 hours of initial pericardiocentesis. Pericardial catheters enabled repeated large volume PE drainage in 4 cases (median 10.6ml/kg, range 8-5-10.6). Conclusions Pericardial catheters appear to offer a safe alternative to needle pericardiocentesis. Minimal sedation is required for placement, and they can be placed quickly. Their indwelling nature and use was not associated with a higher rate of arrhythmia compared to that of needle pericardiocentesis alone, and may be beneficial in the event that clinically significant PE recurs.

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