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Cardiomegaly in a premature neonate after venous umbilical catheterization

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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.

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Abbreviations

UVC:

Umbilical venous catheter

UAC:

Umbilical arterial catheter

PICC:

Peripherally inserted central catheter

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Conflicts of interest statement

None declared.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, University of Berne, Berne, Switzerland

    Luregn Jan Schlapbach, Mathias Nelle & Felicity Jane McDougall

  2. Neonatology and Pediatric Intensive Care, University Children’s Hospital Zürich, Steinwiesstr. 75, 8032, Zürich, Switzerland

    Luregn Jan Schlapbach

  3. Division of Pediatric Cardiology, Department of Pediatrics, University of Berne, Berne, Switzerland

    Jean-Pierre Pfammatter

Authors
  1. Luregn Jan Schlapbach
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  2. Jean-Pierre Pfammatter
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  3. Mathias Nelle
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  4. Felicity Jane McDougall
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Correspondence to Luregn Jan Schlapbach.

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Schlapbach, L.J., Pfammatter, JP., Nelle, M. et al. Cardiomegaly in a premature neonate after venous umbilical catheterization. Eur J Pediatr 168, 107–109 (2009). https://doi.org/10.1007/s00431-008-0704-3

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  • DOI: https://doi.org/10.1007/s00431-008-0704-3

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