The Efficacy of Corticosteroids, NSAIDs, and Colchicine in the Treatment of Pediatric Postoperative Pericardial Effusion

Abstract

The objective of this study is to investigate and compare the efficacy of corticosteroids, NSAIDs, and colchicine in treating postoperative pericardial effusion (PPE) following cardiac surgery in the pediatric setting, on the basis of available literature. To investigate and compare the efficacy of corticosteroids, NSAIDs, and colchicine in treating postoperative pericardial effusion (PPE) following cardiac surgery in the pediatric setting, on the basis of available literature. A systematic review was conducted by carrying out a database search in PubMed on April 20th, 2021. An English language filter was added, but no time restrictions were applied. Lack of pediatric literature prompted a broadening of the search to include adult literature. One pediatric and four adult studies were included, but the pediatric evidence was not found to be of satisfactory quality, and the findings of adult literature could not be readily generalized to the pediatric setting. No well-founded conclusions could be drawn regarding the efficacy of corticosteroids, NSAIDs, or colchicine in treating PPE, as a striking lack of evidence for their efficacy in the pediatric setting were revealed. A knowledge gap was found in the literature, indicating a need for good-quality randomized controlled trials to bridge this gap.

COVID-19-Induced Cardiac Tamponade: A Case Study and a Literature Review

“…The supportive therapy on pericardial effusion includes anti-inflammatories (non-steroidal anti-inflammatory drugs [NSAIDs], colchicine), steroids, uricosuric agents, and antivirals [ 15 , 16 ]. Corticosteroids have potent anti-inflammatory properties reducing the inflammation of the pericardium, alleviating the symptoms, improving the effusion, and preventing further complications [ 17 , 18 ].…”

Pericardial Effusions After the Arterial Switch Operation: A PHIS Database Review

“…Future studies should include awareness of medication regimen as it has been suggested that empiric aspirin utilization confers a lower risk of PCE in adults after cardiac surgery. 6 …”

“…Future studies should include awareness of medication regimen as it has been suggested that empiric aspirin utilization confers a lower risk of PCE in adults after cardiac surgery. 6 Although it is unlikely that a patient undergoing ASO had the procedure at another hospital, it is possible that there are duplicated patients in the cohort if they move from one hospital to another. Additionally, while PHIS tracks longitudinal hospital encounters at the same institution, this study likely does not identify all follow-up encounters since they may present to another hospital for subsequent care.…”

“… 1 – 4 Despite the consequences of PCE, there is little evidence describing risk factors for development or guidance for perioperative management. 5 – 8 …”

“…[1][2][3][4] Despite the consequences of PCE, there is little evidence describing risk factors for development or guidance for perioperative management. [5][6][7][8] Reported prevalence of postoperative PCE ranges from 1.1% to 65%, with cardiopulmonary bypass time, atrial septal defect (ASD) repair, genetic abnormalities, and first-time cardiac surgery having been identified as independent risk factors. [9][10][11][12][13][14] However, these published studies are limited to mostly singlecenter reports encompassing various congenital heart disease (CHD) subtypes and surgeries, making the meaningful extrapolation to individual populations difficult.…”