Detection of pulsus paradoxus associated with large pericardial effusions in pediatric patients by analysis of the pulse-oximetry waveform

Pediatrics
Robert F TamburroKimberly Womback

Abstract

To determine whether analysis of the pulse-oximetry waveform can be useful in detecting the pulsus paradoxus associated with large pericardial effusions in pediatric patients. A retrospective review of charts of 8 pediatric patients (age range: 5-19 years) who had echocardiographic evidence of large pericardial effusion, subsequently underwent pericardiocentesis, and had pulse-oximetry waveform tracings obtained before and after pericardiocentesis within an 18-month period was conducted in 2 tertiary-care pediatric intensive care units. We analyzed the pulse-oximetry waveform tracings for the presence of a pulsus paradoxus. Other abstracted data included clinical evidence of tamponade, echocardiographic findings, and the volume of pericardial fluid aspirated. Before pericardiocentesis, a decrease in the highest value of the upper plethysmographic peak of the pulse-oximetry waveform was observed during inspiration in each patient. Echocardiographic evidence of large pericardial effusion with compromised cardiac filling was also present in each patient. Only 6 of these patients had clinical evidence of cardiac tamponade at that time, 4 with a documented pulsus paradoxus using standard methods of blood pressure analysis. After per...Continue Reading

References

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Citations

Dec 12, 2007·Intensive Care Medicine·Bernhard FreyChristian Balmer
Jul 31, 2008·Pediatric Cardiology·Hamid AmoozgarZahra Serati
Jun 30, 2005·Respiratory Research·Donald H ArnoldJames S Hagood
Oct 7, 2009·Clinical Medicine & Research·Sara K JohnsonSteven H Yale
Dec 2, 2015·The Journal of Pediatrics·Lindsay MillsRobert Gow
Dec 9, 2008·Emergency Medicine Clinics of North America·James M Callahan
Sep 30, 2006·Clinical Cardiology·Mau Kenneth E StoneBernard J Rubal
Jun 15, 2017·Current Opinion in Critical Care·Azriel Perel
Jul 12, 2005·Issues in Comprehensive Pediatric Nursing·Deanna Mulvihill
Apr 23, 2004·Intensive Care Medicine·Bernhard Frey, Andrew Argent

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