[Central catheters and pericardial effusion: results of a multicentric retrospective study].
OBJECTIVE
To evaluate the use of neonatal central venous catheters (CVC) in 38 french neonatal units and occurrence of pericardial effusion (PCE) over the past 5 years.


METHODS
We surveyed 38 units with a questionnaire and studied the cases of PCE in five units.


RESULTS
Response rate was 89% (34/38). Accepted CVC tip positions were: junction of right atrium (RA) and vena cava (VC) 76%, VC 58%, RA 11%. Fifty percent of the centers had been exposed to PCE. 16 cases of PCE were studied. Median gestational age was 31 weeks (range: 26.1 to 40 weeks). Median time from insertion: 3.2 days (range: 0.4-13.5). In all cases CVC tip was intracardiac at insertion with inadequate withdrawing in 13 cases. Sudden cardiac collapse was reported in eight cases, and unexplained cardiorespiratory instability in six cases. Echography showed PCE in 14 cases. One diagnosis was post-mortem. CVC was withdrawn in 12 patients and 13 underwent pericardiocentesis. Four patients died and two had neurological sequelae.


CONCLUSIONS
PCE was associated with intracardiac CVC tip. The CVC tip should be controlled with radiography or echography outside the cardiac silhouette. PCE diagnosis must be considered in face of unexplained cardiovascular decompensation of neonate with CVC.
Jouvencel
P
P
Service de pédiatrie et néonatologie, 13, avenue Interne J.-Loëb, centre hospitalier de la Côte Basque, 64100 Bayonne, France. pjouvencel@chicb.com
Tourneux
P
P
Pérez
T
T
Sauret
A
A
Nelson
J R
JR
Brissaud
O
O
Demarquez
J L
JL
D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D010490:Pericardial Effusion / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors