Emergency Autotransfusion for Managing Iatrogenic Hemorrhagic Pericardial Effusion
Bibliographic record
Abstract
Iatrogenic hemorrhagic pericardial effusion (IHPE) is one of the major complications encountered in daily percutaneous intracardiac interventions. A 79-year-old man was scheduled for percutaneous left atrial appendage closure (PLAAC) at our department. He had non-valvular atrial fibrillation, with a contraindication to oral anticoagulants because of a history of recurrent significant intestinal bleeding with angiodysplasia. During the deployment of the PLAAC device (Watchman device), patient became hemodynamically unstable with a typical decrease in the systolic arterial pressure of more than 10 mm Hg during inspiration (pulsus paradoxus) because pericardial tamponade occurred due to perforation of the left atrial appendage. We report our successful experience with management of IHPE by immediate pericardiocentesis, insertion of percutaneous catheter drainage (PCD), and retransfusing drained pericardial blood through a central venous line. IHPE is not uncommon complication in daily percutaneous intracardiac interventions. Pulsus paradoxus is the most important clinical sign of cardiac tamponade. Our approach by immediately retransfusing drained pericardial blood through a central venous line allowed rapid physiologically appropriate recovery. Future consensus of opinion of experts focusing on autotransfusion in such cases is needed. J Med Cases. 2017;8(4):114-116 doi: https://doi.org/10.14740/jmc2789w
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".