title: An unusual case presentation: pericardial tamponade complicating central venous catheter.
abstract: The use of central venous catheters in very low birthweight infants to provide adequate calories for growth is an integral part of the care of the high-risk neonate. The use of surgically placed Broviac catheters has been associated with infectious and mechanical complications. Recently, there has been increasing use of silastic central venous catheters inserted through a peripheral vein and advanced to the right atrium. These catheters have a reported low rate of complications. However, we report a case of a very low birthweight infant in whom a peripherally inserted silastic catheter perforated the wall of the right atrial appendage and led to fatal pericardial tamponade. This is a very rare but nearly always fatal complication. It is potentially avoidable by careful placement of the tip of the central venous catheter, so that it is not impinging on a wall of the heart. Serial venograms may be useful to reconfirm the position of the catheter.
authors.affiliation: Division of Neonatology/Pediatric Pulmonology, Childrens Hospital Los Angeles, CA 90027.
authors.forename: M
authors.initials: M
authors.lastname: Garg
authors.forename: C C
authors.initials: CC
authors.lastname: Chang
authors.forename: R J
authors.initials: RJ
authors.lastname: Merritt
mesh_terms: D002305:Cardiac Tamponade / Q000209:etiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D004200:Diseases in Twins; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D010490:Pericardial Effusion / Q000209:etiology*; D010496:Pericardium / Q000293:injuries; D012826:Silicone Elastomers
chemical_list: D012826:Silicone Elastomers