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March 1984

Early Drainage of Pericardial Effusion

Author Affiliations

Fresno, Calif

Arch Intern Med. 1984;144(3):649. doi:10.1001/archinte.1984.00350150263056

To the Editor.  —The editorial by Leehey et al,1 published in the September 1983 Archives, concerning early drainage of pericardial effusions with a chest tube overemphasized an invasive procedure and used an unjustified eponym.Leehey et al recommended early drainage of pericardial effusions by inserting a chest tube into the pericardial cavity in patients with dialysis pericarditis because of the high incidence of serious complications, eg, tamponade and sudden death. Since 1975, I have participated in the treatment of about 40 to 60 patients with dialysis pericarditis and pericardial rub who had pericardial effusion of about 300 mL or more confirmed by echocardiography. These patients were treated with four to six dialyses per week, and 80% of these patients also received indomethacin therapy.2 There were four pericardiocenteses, three pericardiectomies, and no deaths. The incidence of serious complications of dialysis pericarditis seems to be higher in the article by

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