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Article type: Research Article
Authors: Mueller, Andreas | Franz, Axel | Bartmann, Peter | Heep, Axel
Affiliations: Department of Neonatology, Children's Hospital, University of Bonn, Germany
Note: [] Corresponding author: Dr. Andreas Mueller, Department of Neonatology, Children's Hospital, University of Bonn, Adenauerallee 119, D-53113 Bonn, Germany. Tel.: +49 228 287 15449; Fax: +49 228 287 16291; E-mail: a.mueller@ukb.uni-bonn.de
Abstract: Pericardial tamponade occurs rarely as severe complication of umbilical venous catheterization. We describe a preterm infant with congenital hydrothorax and mild hydrops fetalis who required umbilical venous catheterization for inotropic support and parenteral nutrition. The correct position of the UVC was verified by echocardiography and chest x-ray. The infant developed respiratory failure because of an increasing right sided pleural effusion at day 4 resulting in a mediastinal shift to the left side. During drainage of the pleural effusion the infant suddenly presented with decreasing blood pressure and subsequent bradycardia requiring resuscitation. Immediate transthoracic echocardiography revealed a cardiac tamponade due to pericardial effusion and pericardiocentesis was successfully performed promptly. The patient's conditions stabilized and he was discharged from hospital at 6 weeks postnatal age without apparent sequelae. Cardiac tamponade may occur despite correct position of the umbilical venous catheter. In our case the mediastinal shift presumably caused the atrial perforation by the catheter.
Keywords: Umbilical venous catheterization, cardiac tamponade, pericardial effusion, chylothorax, infant, newborn
DOI: 10.3233/NPM-2009-0083
Journal: Journal of Neonatal-Perinatal Medicine, vol. 2, no. 4, pp. 295-298, 2009
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