Hydromediastinum associated with a peripherally inserted central venous catheter in a newborn infant

Abstract

We report a case of hydromediastinum in a newborn associated with a peripherally inserted central venous catheter. A 9-day-old male infant with total parenteral nutrition via a peripherally inserted central venous catheter had acute respiratory distress. A chest radiograph showed a widened mediastinal shadow and left pleural effusion, and sonography revealed fluid collection in the mediastinum and bilateral hydrothorax. Sonography is useful in the diagnosis of hydromediastinum when infants treated with peripherally inserted central venous catheters have acute respiratory distress.

Massive pleural effusion on the contralateral side of a venous peripherally inserted central catheter

“…Pezzati et al suggested that polyurethane PICCs (as the one we used in the present case) are stiffer and less flexible than silastic ones and can more easily damage the vascular wall and cause perforation . However, several previous studies have shown that hydrothorax and cardiac tamponade occur regardless of the size or material of the PICC …”

“…1 However, several previous studies have shown that hydrothorax and cardiac tamponade occur regardless of the size or material of the PICC. 8,9,15 After placement of the PICC, the correct position of the tip of the catheter must be confirmed at the junction of the vena cava in the right atrium. 2,5,6 Several methods can be used in confirming line placement, such as plain radiography, contrast medium injection, computed radiography, ultrasonography, intra-atrial electrocardiography monitoring, and fluoroscopic guidance.…”

“…[5][6][7] Ultrasonography is useful for diagnosis of pleural and pericardial effusions when infants treated with PICC suffer from acute respiratory distress. 1,8 Pezzati et al reported PICC complications with an incidence of 1.8% in an 8-year retrospective case series in newborns weighing less than 1,500 g. 1 In a prospective series of 100 consecutive PICCs in very low-birth-weight infants over a 2year period, Leip€ al€ a et al reported a 3% incidence of complications. 9 We hereby report the case of a preterm neonate with unilateral massive hydrothorax causing acute respiratory distress associated with PICC misplacement on the contralateral side of the catheter insertion.…”

“…These effusions may be life‐threatening, unless timely diagnosis and adequate interventions are performed . Ultrasonography is useful for diagnosis of pleural and pericardial effusions when infants treated with PICC suffer from acute respiratory distress …”

Hidroneumotórax secundario a extravasación de nutrición parenteral al espacio pleural: informe de caso

“…Es también más rápida comparada con la técnica convencional; en consecuencia, se convierte en una técnica superior a la guiada únicamente por reparos anatómicos (6,8). Sin embargo, depende del entrenamiento del personal médico: pediatras, neonatólogos, radió-logos y anestesiólogos.…”