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Treating Postoperative Pericardial Effusion With Nonsteroidal Anti-inflammatory Drug Therapy FREE

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The summary below is from the full report titled “Nonsteroidal Anti-inflammatory Drug Treatment for Postoperative Pericardial Effusion. A Multicenter Randomized, Double-Blind Trial.” It is in the 2 February 2010 issue of Annals of Internal Medicine (volume 152, pages 137-143). The authors are P. Meurin, J.Y. Tabet, G. Thabut, P. Cristofini, T. Farrokhi, M. Fischbach, B. Pierre, A. Ben Driss, N. Renaud, M.C. Iliou, and H. Weber, for the French Society of Cardiology.

Ann Intern Med. 2010;152(3):I-32. doi:10.7326/0003-4819-152-3-201002020-00001
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What is the problem and what is known about it so far?

A tough bag of connective tissue surrounds the heart. After cardiac surgery, fluid often collects in the space between this bag and the heart. If too much fluid collects, its pressure can prevent the heart from pumping enough blood to supply the body, a condition known as cardiac tamponade. To prevent this problem, most doctors prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) because inflammation is thought to be the cause of the fluid accumulation, especially when it is present 7 or more days after surgery. Expert recommendations and clinical guidelines encourage this practice.

Why did the researchers do this particular study?

No studies have shown that NSAIDs are effective for this purpose.

Who was studied?

196 patients with a moderate to large amount of fluid more than 7 days after cardiac surgery.

How was the study done?

The researchers randomly assigned patients to receive either placebo or diclofenac, an NSAID, for 14 days.

What did the researchers find?

The effusions decreased by about the same amount in both groups, and about the same number of patients in both groups developed cardiac tamponade.

What were the limitations of the study?

The study had too few patients to detect small beneficial effects from diclofenac.

What are the implications of the study?

Doctors should stop prescribing NSAIDs for this purpose because these drugs have no or only small beneficial effects.





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