Porcine (Sus scrofa) Model of Cardiac Tamponade and Development of an Animal Model for Pericardiocentesis, a Pilot Study
Abstract
Introduction- Pericardiocentesis is a lifesaving skill providers should know how to perform. Though cadaveric, mannequin, and inanimate models of pericardiocentesis have been developed, many lack in vivo anatomic relationships and the hemodynamic feedback associated with successful pericardiocentesis. Methods- A large animal model of cardiac tamponade was created in 5 Yorkshire-cross swine. The pericardium was accessed through an anterolateral thoracotomy and a 14F pigtail catheter was placed into the pericardium using Seldinger technique. Colored saline was then instilled into the pericardium while hemodynamics were monitored. Cardiac tamponade was defined as 25% decrease in systolic blood pressure. A cohort of participants then practiced ultrasound assisted sub-xiphoid pericardiocentesis using the model. Results- Cardiac tamponade was achieved after instillation of an average of 204% (range 100- 340 cc, SD 99 cc). A direct relationship between volume in the pericardium and pericardial pressure was observed. Nine participants performed pericardiocentesis using the model with a success rate of 88.9% after 3 attempts. Feedback was provided by retrieval of colored fluid and measurable changes in mean arterial pressure. Conclusions - This large animal model of pericardiocentesis serves as another avenue to practice this invasive procedure in conjunction with large animal trauma labs. This model also allows for the practice of both ultrasound diagnosis of cardiac tamponade as well as surgical release of cardiac tamponade through an ED thoracotomy in a realistic manner.
Document Details
- Document Type
- Technical Report
- Publication Date
- Mar 18, 2021
- Accession Number
- AD1126282
Entities
People
- Timothy Guenther
Organizations
- David Grant USAF Medical Center