Cardiomegaly in a premature neonate after venous umbilical catheterization

Abstract

Umbilical venous catheters allow rapid central access in neonates, but may be associated with various complications. We present a case of a newborn with pericardial effusion following umbilical venous catheterization. An extremely low birth weight infant was intubated for respiratory distress syndrome and had umbilical venous and arterial lines in place. Massive cardiomegaly was noted on the subsequent chest X-ray. Echocardiography revealed a large pericardial effusion without signs of tamponade. After removing the catheter, the effusion gradually resolved. While pericardial effusion is a well-known complication of percutaneous long central lines, only a few case reports have documented sudden cardiovascular compromise associated with umbilical venous catheters. Pericardial effusion may be asymptomatic and should be suspected in infants with central catheters and progressive cardiomegaly. The prompt removal of catheters and, if signs of cardiac tamponade are present, emergency pericardiocentesis may prove to be life-saving.

Early pericardial effusion as complication of umbilical venous catheter insertion in extreme preterm baby: A case report

“…Central venous catheterization is widely used in the neonatal intensive care unit to provide parenteral nutrition and other solutions for critically ill neonates. Presence of the tip of the UVC in the cardiac chambers considered to be one of the main risk factors for PCE with cardiac tamponade (CT) 5 . Other factors that have been associated with pericardial effusion are extreme preterm infants, misplaced of CVC, and parenteral nutrition infusion 6,7 .…”

“…Presence of the tip of the UVC in the cardiac chambers considered to be one of the main risk factors for PCE with cardiac tamponade (CT). 5 Other factors that have been associated with pericardial effusion are extreme preterm infants, misplaced of CVC, and parenteral nutrition infusion. 6,7 All these risk factors presented in the reported case.…”

Cateter central de inserção periférica: padronização técnica e educacional em unidade de cuidados neonatais

“…Nas circunstâncias em que essa extremidade fica na vertical com a parede cardíaca, as oportunidades de um trauma direto e erosão são grandes, além de que a ocorrência de infusão de substâncias hiperosmolares potencializam o quadro por causarem uma lesão osmótica do tecido, levando a perfusão atrial, tamponamento cardíaco e arritmias (SCHLAPBACH et al, 2009;ONAL et al, 2004apud KIDO et al, 2015.…”

Evisceration of small bowel from umbilical vein catheterization in a preterm African neonate: An uncommon complication

“…Complications following this procedure have been variously documented [3][4][5][6][7][8] COSECSA/ASEA Publication -East and Central African Journal of Surgery. 2016 ; Volume 21 Number 1 However, evisceration of the small bowel following this procedure as reported in this paper is very uncommon and has not been reported previously in literature.…”