Tamponade a rare cause of shock in patients with pancreatitis: Difficulty of diagnostic in patients with positive pressure ventilation

Management of Acute Pancreatitis in the Pediatric Population

“…Routine adult cardiac monitoring for non-intensive care unit (ICU) patients includes routine vitals every 8 hours to access cardiovascular status (70). In addition to this, rare cases of cardiac tamponade and atrial fibrillation have been reported in AP and should be considered during standard cardiac workup initiated in patients with unexplained hypotension, shortness of breath and/or chest pain (89)(90)(91)(92).…”

Cardiac tamponade, an unusual complication of acute pancreatitis

“…Regardless of the cause, the rapid accumulation of pericardial fluid, even a few millilitres,5 can lead to tamponade. The diagnosis should be made promptly, as suggested by current guidelines, by transthoracic echocardiography; this might be difficult in patients with mechanical ventilation;6 initial treatment remains the rapid resolution of haemodynamic deterioration by pericardiocentesis (class IA) 7. Pericardiocentesis should be performed in all patients with haemodynamic impairment demonstrated with clinical and echocardiographic signs such as pulsus paradoxus, Beck’s triad and transmitral flow variability >25% in pulsed Doppler; in addition to pericardiocentesis, there have been some case reports of patients treated with somatostatin8 or its analogue, octreotide acetate, especially in patients with chronic effusions 9.…”