title: [Serious complications of sternal puncture].
abstract: Fatal complications of sternal puncture are, as a rule, the result of penetration of the needle through the sternum followed by lesion of the pericardium and myocardium and finally pericardial tamponade and death. Thirty-four such cases are studied with a view to the technique and especially the site on the sternum where the puncture was made. It was supposed that the punctures in the sternum in the fatal cases were performed below the level of the second intercostal space and that that was the primary cause of the fatal outcome as the heart and pericardium here are very close to the sternum. Punctures at the level of the second intercostal space and higher should be reasonably safe. To the astonishment of the author, it was found that many of the fatal punctures were made in the sternum at the level of the second intercostal space or higher. The many reports in the literature were examined again and it was concluded that the complications might be due to inexperience and lack of training of the person who performed the puncture. It is concluded that puncture of the iliac crest with marrow aspiration and biopsy is preferable for better diagnostic value and a safer procedure.
authors.forename: J
authors.initials: J
authors.lastname: Bichel
mesh_terms: D002305:Cardiac Tamponade / Q000209:etiology; D006335:Heart Injuries / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D010496:Pericardium / Q000293:injuries; D011677:Punctures / Q000009:adverse effects* / Q000379:methods; D013249:Sternum
vernacular_title: Alvorlige komplikationer ved sternalpunktur.