title: Cardiomegaly in a premature neonate after venous umbilical catheterization.
abstract: Umbilical venous catheters allow rapid central access in neonates, but may be associated with various complications. We present a case of a newborn with pericardial effusion following umbilical venous catheterization. An extremely low birth weight infant was intubated for respiratory distress syndrome and had umbilical venous and arterial lines in place. Massive cardiomegaly was noted on the subsequent chest X-ray. Echocardiography revealed a large pericardial effusion without signs of tamponade. After removing the catheter, the effusion gradually resolved. While pericardial effusion is a well-known complication of percutaneous long central lines, only a few case reports have documented sudden cardiovascular compromise associated with umbilical venous catheters. Pericardial effusion may be asymptomatic and should be suspected in infants with central catheters and progressive cardiomegaly. The prompt removal of catheters and, if signs of cardiac tamponade are present, emergency pericardiocentesis may prove to be life-saving.
authors: Division of Neonatology, Department of Pediatrics, University of Berne, Berne, Switzerland. luregn.schlapbach@bluewin.ch
authors: Luregn Jan
authors: LJ
authors: Schlapbach
authors: Jean-Pierre
authors: JP
authors: Pfammatter
authors: Mathias
authors: M
authors: Nelle
authors: Felicity Jane
authors: FJ
authors: McDougall
mesh_terms: D006332:Cardiomegaly / Q000175:diagnosis* / Q000209:etiology*; D002406:Catheterization, Peripheral / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D010288:Parenteral Nutrition; D010490:Pericardial Effusion / Q000209:etiology*; D011183:Postoperative Complications; D014471:Umbilical Veins / Q000601:surgery*