Unusual case of pericardial tamponade due to umbilical venous
catheterization in a newborn with congenital chylothorax: Case report and
review of the literature
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:
[email protected]
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.
