Rapidly Progressive Pericardial Effusion and Cardiac Tamponade in a Term Infant with an Umbilical Venous Catheter: A Case Report

Pericardial effusion (PCE) in neonates has various clinical presentations depending on the amount and speed of fluid accumulation and can cause cardiac tamponade (CT). We report a case of rapidly accumulating PCE and near-fatal CT with an umbilical venous catheter successfully resolved by emergent echo-guided pericardiocentesis in a term infant who had been hospitalized with meconium aspiration syndrome and persistent pulmonary hypertension. This case report suggests that if a patient with an intracardiac umbilical catheter shows sudden cardiopulmonary instability, the possibility of PCE and CT should be considered. Furthermore, if necessary, emergency drainage of the PCE and removal of the umbilical catheter should be immediately performed.

[1]  S. Domingues,et al.  Neonatal pericardial effusion: case report and review of the literature , 2020 .

[2]  S. Unal,et al.  Pleural and Pericardiac Effusion as a Complication of Properly Placed Umbilical Venous Catheter , 2017, Journal of neonatal surgery.

[3]  Kyong-Soon Lee,et al.  Perforations associated with peripherally inserted central catheters in a neonatal population , 2017, Pediatric Radiology.

[4]  Dorothy A Shannon.  Central Venous Catheter-Induced Pericardial Effusion in a Neonate: A Case Study and Recommendations for Practice , 2014, Neonatal Network.

[5]  K. Maruyama,et al.  Complications of peripherally inserted central venous catheter in Japanese neonatal intensive care units , 2013, Pediatrics international : official journal of the Japan Pediatric Society.

[6]  Gopal Srinivasan,et al.  Migration Patterns of Peripherally Inserted Central Venous Catheters at 24 Hours Postinsertion in Neonates , 2013, American Journal of Perinatology.

[7]  P. McNamara,et al.  The Use of Targeted Neonatal Echocardiography to Confirm Placement of Peripherally Inserted Central Catheters in Neonates , 2011, American Journal of Perinatology.

[8]  P. McNamara,et al.  Targeted neonatal echocardiography in the neonatal intensive care unit: practice guidelines and recommendations for training:. , 2011, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[9]  Jan Marek,et al.  Targeted Neonatal Echocardiography in the Neonatal Intensive Care Unit: practice guidelines and recommendations for training. Writing Group of the American Society of Echocardiography (ASE) in collaboration with the European Association of Echocardiography (EAE) and the Association for European Pedi , 2011, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[10]  A. Ladd,et al.  Pericardial effusion and cardiac tamponade associated with central venous catheters in children: an uncommon but serious and treatable condition. , 2010, Journal of pediatric surgery.

[11]  C. Romagnoli,et al.  Cardiac complications in preterm infants with percutaneous long lines: the importance of early diagnosis. , 2008, Resuscitation.

[12]  M. Nelle,et al.  Cardiomegaly in a premature neonate after venous umbilical catheterization , 2008, European Journal of Pediatrics.

[13]  G. Marx,et al.  Etiology, Management, and Outcome of Pediatric Pericardial Effusions , 2007, Pediatric Cardiology.

[14]  J. Pettit.  Assessment of infants with peripherally inserted central catheters: Part 1. Detecting the most frequently occurring complications. , 2002, Advances in neonatal care : official journal of the National Association of Neonatal Nurses.

[15]  G. Rosenthal,et al.  Pericardial effusion and tamponade in infants with central catheters. , 2002, Pediatrics.

[16]  R. Green,et al.  Changes in upper extremity position cause migration of peripherally inserted central catheters in neonates. , 2002, Pediatrics.