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Bloody Pericardial Fluid or Intracardiac Blood?: A Method for Quick and Accurate Differentiation

JOHN R. STONE, M.D.; and RICHARD H. MARTIN, M.D., F.A.C.P.
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▸Requests for reprints should be addressed to John R. Stone, M.D., Division of Cardiology, University of Missouri Medical Center, Columbia, Mo. 65201.


Columbia, Missouri


Ann Intern Med. 1972;77(4):592-594. doi:10.7326/0003-4819-77-4-592
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Indocyanine green dye was injected through the pericardiocentesis needle from which bloody fluid had been aspirated in two patients with cardiac tamponade. Earpiece densitometry allowed immediate determination of the source of the fluid and abrupt termination of the procedure without sequels in the patient, in whom the needle had entered the heart. This method of determining the source of bloody pericardiocentesis fluid can be carried out rapidly at the bedside with portable equipment and absolutely excludes an intracardiac or vascular source of blood. If no dye appears in the ear after injection through the pericardiocentesis needle, the recording system should be checked by a second injection of indocyanine-green dye, this time intravenously. A normal cardiac output curve will be recorded from the latter injection if the system is intact.

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