Document Detail

Cardiac tamponade and pericardial effusion due to venous umbilical catheterization.
MedLine Citation:
PMID:  16188754     Owner:  NLM     Status:  MEDLINE    
AIM: We present three cases of neonatal cardiac tamponade due to umbilical venous catheterization, a rare, but potentially fatal complication. METHODS: Timely diagnosis was made by echocardiography, and an urgent pericardiocentesis revealed TPN fluid. Perforation of the cardial wall was proven by contrast X-ray showing contrast diffusing into the pericardial space. DISCUSSION: Most frequently, perforation has a delayed course and results from endothelial injury, caused by the hyperosmolar fluids, leading to transmural necrosis and thrombosis. Subsequently, the fluid diffuses transmurally across the myocardium into the pericardium. As migration of the catheter tip can occur, we suggest that its position should be checked immediately after insertion and twice a week thereafter. CONCLUSION: Pericardial effusion and cardiac tamponade should be considered in any infant with a central venous line who develops a rapid, unexplained clinical deterioration. Timely diagnosis and drainage has been proven to be life-saving.
Marijke Traen; Elisabeth Schepens; Sabine Laroche; Bart van Overmeire
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  94     ISSN:  0803-5253     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-09-28     Completed Date:  2006-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  626-8     Citation Subset:  IM    
Department of Paediatrics, Division of Neonatology, Antwerp University Hospital, Edegem, Belgium.
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MeSH Terms
Cardiac Tamponade / complications,  etiology*,  ultrasonography
Catheterization, Central Venous / adverse effects*
Infant, Newborn
Pericardial Effusion / complications,  etiology*
Umbilical Veins*

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