{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:48:44Z","timestamp":1784180924013,"version":"3.55.0"},"reference-count":25,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,6,13]],"date-time":"2022-06-13T00:00:00Z","timestamp":1655078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Large pericardial effusion (LPE) is associated with high mortality. In patients with cardiac tamponade or with suspected bacterial etiology of pericardial effusion, urgent pericardial decompression is necessary. Aim: The aim of the present retrospective study was to assess the short-term results of pericardial decompression combined with prolonged drainage in LPE. Material: This study included consecutive patients with LPE who had been treated with pericardial fluid drainage between 2007 and 2017 in the National Tuberculosis and Lung Diseases Research Institute. Methods: Echocardiographic examination was used to confirm LPE and the signs of cardiac tamponade. Pericardiocentesis or surgical decompression were combined with pericardial fluid (PF) drainage. Short-term effectiveness of therapy was defined as less than 5 mm of fluid behind the left ventricular posterior wall in echocardiography. Results: The analysis included 74 patients treated with pericardial fluid drainage (33 female and 41 male), mean age 58 years, who underwent pericardial decompression. Out of 74 patients, 26 presented with cardiac tamponade symptoms. Pericardiocentesis was performed in 18 patients and pericardiotomy in 56 patients. Median PF drainage duration was 13 days. In 17 out of 25 patients with neoplastic PF, intrapericardial cisplatin therapy was implemented. In 4 out of 49 patients with non-malignant PF, purulent pericarditis was recognized and intrapericardial fibrinolysis was used. Short-term effectiveness of the therapy was obtained in all of patients. Non-infective complications were noted in 16% of patients and infective ones in 10%. Conclusion: Pericardial decompression combined with prolonged PF drainage was safe and efficient method of LPE treatment.<\/jats:p>","DOI":"10.3390\/diagnostics12061453","type":"journal-article","created":{"date-parts":[[2022,6,13]],"date-time":"2022-06-13T22:00:38Z","timestamp":1655157638000},"page":"1453","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Large Pericardial Effusion\u2014Diagnostic and Therapeutic Options, with a Special Attention to the Role of Prolonged Pericardial Fluid Drainage"],"prefix":"10.3390","volume":"12","author":[{"given":"Ma\u0142gorzata","family":"Dybowska","sequence":"first","affiliation":[{"name":"I Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, 01-138 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Szturmowicz","sequence":"additional","affiliation":[{"name":"I Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, 01-138 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"B\u0142asi\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Radiology, National Tuberculosis and Lung Diseases Research Institute, 01-138 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliusz","family":"G\u0105tarek","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, National Tuberculosis and Lung Diseases Research Institute, 01-138 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6162-8748","authenticated-orcid":false,"given":"Ewa","family":"Augustynowicz-Kope\u0107","sequence":"additional","affiliation":[{"name":"Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, 01-138 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Langfort","sequence":"additional","affiliation":[{"name":"Department of Pathology, National Tuberculosis and Lung Diseases Research Institute, 01-138 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2224-5554","authenticated-orcid":false,"given":"Pawe\u0142","family":"Kuca","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Endocrinology and Diabetology, Medical University of Warsaw, 61 Zwirki i Wigury Street, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Witold","family":"Tomkowski","sequence":"additional","affiliation":[{"name":"I Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, 01-138 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2921","DOI":"10.1093\/eurheartj\/ehv318","article-title":"2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC). Endorsed by The European Association for Cardio-Thoracic Surgery (EACTS)","volume":"36","author":"Adler","year":"2015","journal-title":"Eur. Heart J."},{"key":"ref_2","first-page":"587","article-title":"Task Force on the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology. Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology","volume":"7","author":"Maisch","year":"2004","journal-title":"Eur. Heart J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1093\/eurheartj\/ehs372","article-title":"Management of pericardial effusion","volume":"34","author":"Imazio","year":"2013","journal-title":"Eur. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1007\/s11886-021-01539-7","article-title":"New Approaches to Management of Pericardial Effusions","volume":"23","author":"Lazaros","year":"2021","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_5","first-page":"1147","article-title":"Diagnosis of malignant pericarditis: A single-centre experience","volume":"70","author":"Szturmowicz","year":"2012","journal-title":"Kardiol. Pol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1136\/hrt.2007.127746","article-title":"Contemporary trends in the epidemiology and management of cardiomyopathy and pericarditis in sub-Saharan Africa","volume":"93","author":"Mayosi","year":"2007","journal-title":"Heart"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3608","DOI":"10.1161\/CIRCULATIONAHA.105.543066","article-title":"Tuberculous pericarditis","volume":"112","author":"Mayosi","year":"2005","journal-title":"Circulation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2279","DOI":"10.1093\/eurheartj\/ehu217","article-title":"Triage strategy for urgent management of cardiac tamponade: A position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases","volume":"35","author":"Risti","year":"2014","journal-title":"Eur. Heart J."},{"key":"ref_9","first-page":"590","article-title":"Comparison of surgical pericardial drainage with percutaneous catheter drainage for pericardial effusion","volume":"24","author":"Saltzman","year":"2012","journal-title":"J. Invasive Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Dybowska, M., Szturmowicz, M., Opoka, L., Rudzi\u0144ski, P., and Tomkowski, W. (2020). Intrapericardial recombinant tissue plasminogen activator in purulent pericarditis-case series. BMC Cardiovasc. Disord., 27.","DOI":"10.1186\/s12872-020-01674-z"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"412","DOI":"10.3747\/co.22.2698","article-title":"Pericardiocentesis versus pericardiotomy for malignant pericardial effusion: A retrospective comparison","volume":"22","author":"Tremblay","year":"2015","journal-title":"Curr. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1016\/j.chest.2017.11.003","article-title":"Tamponade: Hemodynamic and Echocardiographic Diagnosis","volume":"153","author":"Kearns","year":"2018","journal-title":"Chest"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1161\/01.CIR.0000051366.97361.EA","article-title":"Diagnostic value of pericardial biopsy. Improvement with extensive sampling enabled by pericardioscopy","volume":"107","author":"Seferovic","year":"2003","journal-title":"Circulation"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1161\/CIRCIMAGING.109.921791","article-title":"The role of multimodality imaging in the management of pericardial disease","volume":"3","author":"Verhaert","year":"2010","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_15","first-page":"373","article-title":"Determinants of Survival after Emergency Intrapericardial Cisplatin Treatment in Cancer Patients with Recurrent Hemodynamic Instability After Pericardiocentesis","volume":"32","author":"Darocha","year":"2018","journal-title":"In Vivo"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"197","DOI":"10.5603\/ARM.a2018.0030","article-title":"Intrapericardial cisplatin combined with oral colchicine resulted in long term control of malignant pericardial effusion in the course of metastatic renal cancer","volume":"86","author":"Dybowska","year":"2018","journal-title":"Adv. Respir. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"740","DOI":"10.3748\/wjg.v16.i6.740","article-title":"Pericardiocentesis with cisplatin for malignant pericardial effusion and tamponade","volume":"16","author":"Oida","year":"2010","journal-title":"World J. Gastroenterol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1007\/BF01240144","article-title":"Intrapericardial cisplatin for the management of patients with large malignant pericardial effusion","volume":"120","author":"Tomkowski","year":"1994","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/S0169-5002(96)00631-9","article-title":"Intrapericardial cisplatin for the management of patients with large malignant pericardial effusion in the course of the lung cancer","volume":"16","author":"Tomkowski","year":"1997","journal-title":"Lung Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s00520-003-0533-x","article-title":"Evaluation of intrapericardial cisplatin administration in cases with recurrent malignant pericardial effusion and cardiac tamponade","volume":"12","author":"Tomkowski","year":"2004","journal-title":"Support. Care Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/s11886-020-1254-1","article-title":"Diagnosis and Management of Tuberculous Pericarditis: What Is New?","volume":"22","author":"Isiguzo","year":"2020","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"347","DOI":"10.4103\/ijmy.ijmy_150_19","article-title":"Hospital admissions for tuberculous pericarditis in the United States 2002\u20132014","volume":"8","author":"Stancic","year":"2019","journal-title":"Int. J. Mycobacteriol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Dybowska, M., B\u0142asi\u0144ska, K., G\u0105tarek, J., Klatt, M., Augustynowicz-Kope\u0107, E., Tomkowski, W., and Szturmowicz, M. (2022). Tuberculous Pericarditis-Own Experiences and Recent Recommendations. Diagnostics, 12.","DOI":"10.3390\/diagnostics12030619"},{"key":"ref_24","first-page":"9","article-title":"Interventions for treating tuberculous pericarditis","volume":"13","author":"Wiysonge","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_25","first-page":"10","article-title":"Neglected Tropical Diseases, Other Infectious Diseases Affecting the Heart (the NET-Heart Project). Tuberculosis and the Heart","volume":"6","author":"Saldarriaga","year":"2021","journal-title":"J. Am. Heart Assoc."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/6\/1453\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:28:46Z","timestamp":1760138926000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/6\/1453"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,13]]},"references-count":25,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["diagnostics12061453"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics12061453","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,13]]}}}