Neonatal Med.  2022 Nov;29(4):135-140. 10.5385/nm.2022.29.4.135.

Rapidly Progressive Pericardial Effusion and Cardiac Tamponade in a Term Infant with an Umbilical Venous Catheter: A Case Report

• Park MJ
• Ahn JH
• Lee HJ
• Park HK
• Hwang JK
• Kim CR
• Na JY

• KMID: 2536659
• DOI: http://doi.org/10.5385/nm.2022.29.4.135

Abstract

Pericardial effusion (PCE) in neonates has various clinical presentations depending on the amount and speed of fluid accumulation and can cause cardiac tamponade (CT). We report a case of rapidly accumulating PCE and near-fatal CT with an umbilical venous catheter successfully resolved by emergent echo-guided pericardiocentesis in a term infant who had been hospitalized with meconium aspiration syndrome and persistent pulmonary hypertension. This case report suggests that if a patient with an intracardiac umbilical catheter shows sudden cardiopulmonary instability, the possibility of PCE and CT should be considered. Furthermore, if necessary, emergency drainage of the PCE and removal of the umbilical catheter should be immediately performed.

Keyword

Pericardial effusion; Cardiac tamponade; Central venous catheters

Figure

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  Figure 1. The umbilical venous catheter tip (arrow) remained inside the cardiac silhouette as recorded on chest radiography.

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  Figure 2. Chest X-ray after sudden cardiopulmonary instability showed cardiomegaly when compared to the initial chest radiography.

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  Figure 3. (A) Massive pericardial effusion (arrow) with severe cardiac dysfunction was noted. (B) Pale yellowish serous fluid was aspirated during pericardiocentesis.

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  Figure 4. (A) Recurrence of massive pericardial effusion was noted 2 hours after first pericardiocentesis. (B) An indwelling catheter (arrow) was inserted.

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