Cardiac tamponade and successful pericardiocentesis in an extremely low birth weight neonate with percutaneously inserted central venous line: a case report
1 Cardiology Unit, Ordine Mauriziano Hospital, (Largo Turati n 62), Turin, (10128), Italy
2 Neonatal Intensive Care Unit, Ordine Mauriziano Hospital, (Largo Turati n 62), Turin, (10128), Italy
Cases Journal 2010, 3:15 doi:10.1186/1757-1626-3-15Published: 11 January 2010
Pericardial effusion and cardiac tamponade are rare but life-threatening complications of percutaneosuly inserted central line (PICL) use in extremely low birth weight (ELBW) neonates, with an incidence reported between 0.07% and 2% of PICLs placement. Timely diagnosis and pericardiocentesis has been proven to be life-saving.
The patient was a 620 g birth weight neonate who presented with sudden cardiac instability 18 days after the insertion of a PICL and in spite of a presumed satisfactory position of the catheter tip.
The transthoracic echocardiography demonstrated severe pericardial effusion with evidence of cardiac tamponade.
Successful urgent subxiphoid pericardiocentesis was performed; totally 2 ml of whitish fluid was collected, which resulted consistent to the composition of the hyperosmolar TPN solution infused.
Cardiac tamponade should be considered in any newborn with a peripherally inserted central catheter who presents with cardiorespiratory instability (bradycardia, cyanosis and metabolic acidosis), even when lines are believed to be placed correctly.