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J Pediatr Intensive Care 2024; 13(01): 032-036
DOI: 10.1055/s-0041-1736213
Original Article

Comparison of PLANE Technique versus Standard Echocardiography Guidance for Pediatric Pericardiocentesis

Stephen T. Clark 
1   Division of Pediatric Cardiology, University of Alabama at Birmingham, Birmingham, Alabama, United States
,
Jeffrey A. Alten
2   Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
,
Santiago Borasino
3   Division of Pediatric Cardiology, Section of Cardiac Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
,
Kristal M. Hock 
3   Division of Pediatric Cardiology, Section of Cardiac Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
,
Mark A. Law
1   Division of Pediatric Cardiology, University of Alabama at Birmingham, Birmingham, Alabama, United States
› Author Affiliations Funding Financial support for this article was provided by the Division of Pediatric Cardiology, University of Alabama at Birmingham, and Cincinnati Children's Hospital Medical Center.
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Abstract

Percutaneous pericardiocentesis remains a challenging and potentially dangerous procedure, particularly in small, critically ill patients. We present outcomes of the PLANE (pericardiocentesis using long-axis in-plane real-time echocardiography) technique for pediatric pericardiocentesis compared with a standard echocardiography (ECHO) guidance cohort. This was a retrospective chart review of all children undergoing percutaneous pericardiocentesis from March 2013 to February 2021 at a single center. A total of 78 procedures were performed, 52 utilizing PLANE technique and 26 utilizing standard ECHO-guidance technique. There was 100% technical success rate with only one minor complication for the entire cohort. Procedures were evenly split between the bedside intensive care unit and cardiac catheterization laboratory. PLANE technique was utilized in significantly younger (1.4 vs. 8.4 years, p = 0.008) and smaller (11.1 vs. 31.8 kg, p = 0.007) patients, as well as in most patients deemed high risk (postoperative < 7 days, extracorporeal membrane oxygenation (ECMO) support, and/or weight less than 5 kg; 19/22, p = 0.021). Other patient characteristics were similar between the two groups. There was a trend toward PLANE technique utilization by noncardiology trained operators. The PLANE technique for pediatric pericardiocentesis is safe and effective and can be effectively utilized in small and high-risk patient populations. The technical similarity to other long-axis ultrasound-guided procedures may facilitate adoption and mastery by critical care trained operators.

Keywords

pericardiocentesis - pediatric - intensive care - ultrasound


Publication History

Received: 19 July 2021

Accepted: 26 August 2021

Article published online:
19 October 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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