Pericardiocentesis in a dog скачать в хорошем качестве

Pericardiocentesis in a dog

Pericardiocentesis is a life-saving procedure used to remove excess fluid from the pericardial sac, typically performed in cases of cardiac tamponade or pericardial effusion. Here is a step-by-step guide: Preparation 1. Stabilize the patient: Provide oxygen and address hypotension if present (e.g., administer IV fluids cautiously). 2. Sedation or light anesthesia: Use if necessary to reduce stress but avoid agents that may cause significant cardiovascular depression (e.g., opioids and benzodiazepines are preferred). 3. Imaging: Use echocardiography to confirm the presence of pericardial effusion and guide needle placement. If unavailable, use clinical signs and radiographic evidence. 4. Positioning: Place the dog in left lateral recumbency to avoid puncturing coronary vessels. Equipment Needed • Sterile gloves and drapes • 14-18G long over-the-needle catheter or spinal needle • Extension set and three-way stopcock • Syringe (20-60 mL) • Lidocaine for local anesthesia • Ultrasound (if available) Procedure 1. Identify the site: The preferred site is at the right 4th-6th intercostal space, just dorsal to the costochondral junction. 2. Aseptic preparation: Shave and sterilize the area. 3. Local anesthesia: Infiltrate lidocaine at the puncture site (not shown in video). 4. Needle insertion: Insert the needle or catheter perpendicular to the chest wall, directing it toward the heart. Aspirate as you advance. Avoid entering the myocardium (confirmed by a lack of blood aspiration). 5. Fluid removal: Attach the syringe via the extension set and gently aspirate fluid. Monitor for improvement in clinical signs (e.g., heart rate normalization, reduced jugular distension). 6. Evaluate the fluid: Collect samples for cytology, culture, or biochemical analysis if indicated. Aftercare • Monitor: Observe the dog for signs of recurrence, arrhythmias, or complications. • Supportive care: Continue oxygen and fluid therapy as needed. • Further diagnostics: Determine the underlying cause (e.g., neoplasia, idiopathic, infectious). Complications • Arrhythmias (common but often transient) • Myocardial or lung puncture • Hemorrhage or infection Performing pericardiocentesis under ultrasound guidance whenever possible improves accuracy and reduces complications.