title: Cardiac tamponade and hydrothorax as complications of central venous parenteral nutrition in infants.
abstract: The recent use of soft catheters made of silastic polymeric silicone or polyurethane has decreased the incidence of perforation of great veins or right-sided heart chambers but has not eliminated it as had been hoped. Two premature infants who presented with cardiac tamponade more than 24 hr after the insertion of a 23-gauge silastic catheter for total parenteral nutrition (TPN) administration are described. In one infant, bilateral hydrothorax preceded the occurrence of cardiac tamponade. Osmotic injury to great vessels and/or myocardium seems to be the common mechanism but which these complications of intraluminal catheters are produced. Review of the pediatric literature revealed a proportion of low birth weight infants among the reported cases. Despite a prohibitively high mortality rate, early recognition can prevent a fatal outcome.
authors.affiliation: Department of Pediatrics, University of Oklahoma College of Medicine, Tulsa.
authors.forename: G P
authors.initials: GP
authors.lastname: Giacoia
mesh_terms: D002305:Cardiac Tamponade / Q000209:etiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling; D005260:Female; D006801:Humans; D006876:Hydrothorax / Q000209:etiology*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000209:etiology*; D008297:Male; D010289:Parenteral Nutrition, Total