Pericardial effusion and cardiac tamponade as complications of neonatal long lines: are they really a problem?

Beardsall, Kathryn; White, D K; Pinto, Erin; Kelsall, AW

doi:10.1136/fn.88.4.f292

Cited by 107 publications

(102 citation statements)

References 10 publications

(9 reference statements)

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“…3 Perikardiyal efüz-yon umbilikal venöz kateterli hastaların %2-3'nde oluşur fakat mortalitesi %30-50'dir. 1,2,4 Perikardiyal efüzyonun mortalitesi sıvının genişliğine, hızlı oluşmasına,altta yatan başka hastalığın varlığına, acil tanı ve tedaviye bağlıdır. 5 Perikardiyal efüzyonun oluşmasındaki muhtemel mekanizmalar direk kateter ucunun mekanik hasarı veya hiperosmalar sıvılar nedeniyle oluşan transmural nekroz ve endotelyal hasardır.…”

Section: Discussionunclassified

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Pericardial effusion in a preterm infant after venous umbilical catheterization

Gebeşçe¹,

Keleş²,

Yazgan³

et al. 2013

Sakarya Med J

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ÖzetSantral venöz kateterizasyon çok küçük prematüre bebekleri desteklemek için yenidoğan yoğun bakım ünitelerinde yaygın olarak kullanılır. Perikardiyal effüzyon ve kardiyak tamponad perkutan,umbilikal veya cerrahi olarak yerleştirilen venöz kateterlerin nadir fakat fatal komplikasyonlarıdır.Bu durum kateterin başlangıçtaki intrakardiyak pozisyonuna veya daha sonra yer değiştirmesiyle ilişkilidir.Bu yazıda umbilikal venöz kateter yoluyla sıvı infüzyonu sonrası çok kü-çük prematüre infantta gelişen perkardiyal effüzyon vakası anlatılmış-tır.Akciğer filminde masif kardiyomegali saptandı. Ekokardiyografide tamponad bulguları olmayan geniş perikardiyal effüzyon tespit edildi. Effüzyon kateterin çıkarılmasından ve inflamasyonu azaltmak için ibuprofen verilmesinden sonra geniş ölçüde düzeldi.Takip eden kardiyolojik muayenelerde anatomik ve fonksiyonel patoloji saptanmadı. GirişSatral venöz kateterizasyon yenidoğan yoğun bakım ünitelerinde sıklıkla kullanılır. Perikardiyal efüzyon nadir fakat hayatı tehdit eden bir komplikasyondur. Perikardiyal efüzyon ve tamponad kateter uygulanan bebeklerin %3'ünde görülür ve mortalitesi %30-50 dir.¹ Mortalitesi yüksek olduğundan yenidoğanla ilgilenen hekimlere hatırlatmak amacıyla umblikal venöz kataterli preterm bebekteki perikardiyal efüzyon vakası bu yazıda sunulmuştur. Olgu Sunumu38 yaşındaki sağlıklı annenin beşinci gebeliğinden normal vajinal yolla 25 haftalık olarak doğurtulan kız bebek 640 gr

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Section: Discussionunclassified

“…Santral venöz kateterlerin yanlış yerleştirilmesi (özellikle kateter ucunun sağ atrium içinde olması) perikardiyal efüzyon açısından başlıca risktir. 1,4 Kateter ucu vena kava inferiorun sağ atrima bağlan-dığı yerde ve kalp gövdesinin dışında olmalıdır. Kateter ,mumyalaşan göbek kordonunun retraksiyonu, abdomi-…”

Section: Discussionunclassified

Pericardial effusion in a preterm infant after venous umbilical catheterization

Gebeşçe¹,

Keleş²,

Yazgan³

et al. 2013

Sakarya Med J

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“…The majority of infants with reported pericardial effusion became acutely symptomatic due to cardiac tamponade and deteriorated rapidly with signs of respiratory distress, cyanosis, tachycardia or bradycardia, mottled skin, and arterial hypotension, finally leading to cardiopulmonary arrest not responsive to standard interventions [1,3]. Notably, approximately a quarter of the cases were first diagnosed during post-mortem at autopsy [1]. The mortality is very high (45-65%) [1,3] and those resuscitated successfully improved only after emergency pericardiocentesis was performed.…”

Section: Discussionmentioning

confidence: 99%

“…Pericardial effusion is a well-known complication of peripherally inserted central catheters (PICC), with an estimated incidence of 1.8/1,000 catheters [1]. The majority of infants with reported pericardial effusion became acutely symptomatic due to cardiac tamponade and deteriorated rapidly with signs of respiratory distress, cyanosis, tachycardia or bradycardia, mottled skin, and arterial hypotension, finally leading to cardiopulmonary arrest not responsive to standard interventions [1,3].…”

Section: Discussionmentioning

confidence: 99%

Cardiomegaly in a premature neonate after venous umbilical catheterization

et al. 2008

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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.

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“…In both cases, the initial suspicion was sepsis. Beardsall et al [4] analyzed the number of central venous lines positioning and the number of pericardial effusions and/or cardiac tamponade over the course of 5 years in neonatology units of the United Kingdom. We analyzed about 46,000 central lines, and found that pericardial effusion and/or cardiac tamponade occurred in 1.8 / 1000 venous lines inserted, and found death as a result of this complication in 0.7 / 1000.…”

Section: Fig 1 -Echocardiogram Of Case 1 Showing Severe Pericardial mentioning

confidence: 99%

Tamponamento cardíaco em dois recém-nascidos causado por cateter umbilical

Monteiro¹,

Canale²,

Barbosa³

et al. 2008

Rev Bras Cir Cardiovasc

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Tamponamento cardíaco em dois recém-nascidos causado por cateter umbilical Cardiac tamponade caused by central venous catheter in two newborns AbstractCardiac tamponade secondary to the use of central venous catheter is a rare complication; however, it is potentially reversible when it is caught in time. We report two cases of cardiac tamponade that was diagnosed using a transthoracic echocardiography, followed by urgent pericardiocentesis and surgical pericardial drainage as a complication from umbilical venous catheterization. In one case, the tip of the catheter was properly placed, and in the other case, it was not. In both cases, a hyperosmolar solution was being injected. Although it may be an uncommon situation, it should be always considered as a possibility in a newborn who develops cardiogenic shock without an apparent cause. ResumoTamponamento cardíaco secundário ao uso de cateter venoso central é uma complicação rara, porém potencialmente tratável, quando identificada a tempo. Nós relatamos dois casos de tamponamento cardíaco, diagnosticados por ecocardiograma transtorácico, seguido de pericardiocentese de urgência e drenagem pericárdica cirúrgica como complicação de cateterização venosa umbilical. Em um caso, a ponta do cateter estava adequadamente localizada e, no outro caso, não. Em ambos os casos, solução hiperosmolar estava sendo infundida. Apesar de situação incomum, esta deve ser sempre considerada em neonato, evoluindo com choque cardiogênico sem causa aparente.Descritores: Tamponamento cardíaco. Recém-nascido. Veias umbilicais. Cateterismo Venoso Central/efeitos adversos. Cateterismo/métodos.

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Pericardial effusion and cardiac tamponade as complications of neonatal long lines: are they really a problem?

Cited by 107 publications

References 10 publications

Pericardial effusion in a preterm infant after venous umbilical catheterization

Pericardial effusion in a preterm infant after venous umbilical catheterization

Cardiomegaly in a premature neonate after venous umbilical catheterization

Tamponamento cardíaco em dois recém-nascidos causado por cateter umbilical

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