EC Paediatrics

Background: Pericardial effusion though rare is very important to diagnose and if severe like pericardial tamponade can cause impending death. In a healthy adult there is usually 15 - 50 ml of straw-coloured fluid. There is little data on the normal amount of pericardial fluid in neonates and children to serve as a reference. Measuring normal pericardial fluid in newborns and children is challenging and several formulae have been used to estimate the amount of fluid, but are not totally accurate.

Objectives and Design: A prospective study to measure the amount of pericardial fluid in infants. The study was conducted from February 2014 to September 2015.

Setting: Tertiary Care Maternity and Neonatal center, and Advanced Diagnostic and Research center, Bangalore.

Study Methodology: Neonates and children aged from a few hours after birth to 15 yrs who needed an echocardiogram for various reasons were prospectively studied. We used GE Vivid i and Vivid S5. Pericardial space dimension was measured in late diastole at the maximum point measurable posterior to LV and anterior to RV outflow tract. We measured mid LV-RV level pericardial and epicardial diameters in end diastole in the same axis. Cubing these diameters gives the pericardial and cardiac volumes and the difference is the volume of the pericardial fluid.

Results: We studied neonates and children total of 208, with newborns including gestational age ranging from 27 weeks to 40 weeks , infants and children till 15yrs. About 134 (64%) were in the age group less than 1 year and rest 74 (36%) were of 1 - 15 years age group. Average volume range for newborns to less than 1 year age group varied from 3 ml to 6.87 ml, and more than 1 year ranged from 8.5 ml to 37 ml. When weight was taken into consideration the volume per kg ranged from 1.5 ml per kg in newborns to 0.98 ml per kg in 10 - 15 years age group. None of them had significant cardiac lesions.

Conclusion: A semi quantitative method can be used to assess the amount of pericardial fluid in infants. Neonates have a higher amount of pericardial fluid per kilogram body weight compared to infants.

 Keywords: Neonates; Infants; Children; Normal Pericardial Fluid; Pericardial Effusion

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