Treatment of uremic pericarditis and XXXX .

@entity1 @entity2293 @entity2294 @entity2396 @entity134 @entity954
@entity2396 occurred 161 times in 136 of 1,058 @entity1 undergoing chronic dialysis during a period of 13.7 years. @entity2293 occurred during 27 episodes, while pretamponade occurred in 30. Tamponade was less frequent and resolution of @entity2396 without invasive intervention more frequent when @entity2396 occurred within 2 weeks of initiation of chronic dialysis. Similarly, resolution with conservative therapy was more frequent with first episodes than with recurrences, and when @entity2396 occurred within 3 months of initiation of chronic dialysis. The overall survival was 89.7% and was the same irrespective of the duration of dialysis or whether the @entity2396 was a first episode or a recurrence. We recommend that @entity1 with @entity2396 and no hemodynamic alterations receive intensive hemodialysis, with careful hemodynamic and echocardiographic monitoring, as primary treatment. Invasive intervention is indicated if cardiac tamponade or pretamponade develops, if a @entity2294 increases progressively in size, or if a large effusion persists after ten to 14 days of intensive dialysis. In our experience, the invasive intervention of choice is either formal pericardiectomy or subxiphoid pericardiotomy with intrapericardial @entity134 instillation. In our experience, pericardiocentesis has proven to be a high-risk procedure. It is reserved for emergency circumstances, and then is preferably performed in the operating room just prior to induction of anesthesia for @entity954 .
