Cardiac tamponade and pericardial effusion due to venous umbilical catheterization

Abstract

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.

Hepatic laceration because of malpositioning of the umbilical vein catheter: case report and literature review

“…Thrombosis, embolism, vasospasm, vessel perforation, hemorrhage, infection, gastrointestinal, liver, renal, and limb tissue damage, ascites, hydrothorax, cardiac arrhythmias, pericardial effusion and tamponade, and erosion of the atrium and ventricle have been described in the English literature by now [1,[4][5][6].…”

“…The proper placement of the umbilical vein catheter (UVC) should be just below the right atrial entrance in the inferior vena cava (IVC) [1]. Although a wide experience has been gained since its use was first described in 1947 [3], several mild to serious complications related to the UVC have been reported in the English literature [1,[4][5][6]. Complications related to the liver have a high rate of morbidity and mortality, particularly in small premature newborns [7][8][9][10][11][12][13][14].…”

Cardiomegaly in a premature neonate after venous umbilical catheterization

“…The catheter tip should be positioned at the junction of the vena cava inferior and right atrium, with the tip lying outside the cardiac silhouette. However, catheter inward migration, as experienced in the present case, has been described and is attributed to retraction of the mummifying cord, changes in abdominal girth, and catheter dislocation during manipulations [7,9]. Therefore, even after correct initial placement, the UVC position should be checked regularly using X-ray or ultrasound.…”

“…Contrary to PICC, the incidence of pericardial effusion associated with UVC is unknown, but case reports have documented sudden cardiovascular compromise in infants with UVC due to pericardial tamponade [5,8,9].…”

“…Perforation and catheter migration are thought to occur as a result of both mechanical pressure by the catheter tip repeatedly pushing against the contracting heart wall and endocardial injury caused by hyperosmotic parenteral nutrition fluids [1,9]. The transmural diffusion of parenteral nutrition fluids into the pericardial space further contributes to the accumulation of fluid.…”