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2004, Number 4

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Gac Med Mex 2004; 140 (4)

Cardiac Tamponade in the Neonate As a Complication of a Central Venous Catheter. Case Report.

Lemus-Varela ML, Arríaga-Dávila JJ, Salinas-López MP, Gómez-Vargas JR

Language: Spanish
References: 26
Page: 455-462
PDF size: 586.66 Kb.


ABSTRACT

Background: central venous access is a necessity for the critically-ill newborn who arrives at a Neonatal Intensive Care Unit; despite being considered a relatively safe procedure, it may cause to complications with fatal consequences. Objective: to describe the course of five newborn patients undergoing cardiac tamponade as a complication of central venous catheter. Design: case series. Material and Methods: clinical files of five newborn patients admitted to the NICU who had had central venous catheter installed and underwent cardiac tamponade as a complication were reviewed. Data was collected on a previously designed chart in which identification, venous access, time installed before complication, diagnosis, treatment, and development were registered. Results: expressions of central tendency and dispersion were used for statistical analysis. Four preterm infants and one term infant were analyzed; mean gestational age was 31.5 weeks. Lapse between installation of central venous catheter and appearance of cardiac tamponade was 3 to 12 days, with mean of 6.2 days. The previously mentioned diagnosis was suspected when patients presented sudden hemodynamic dysfunction. Diagnosis was confirmed by echocardiography after resuscitation. Pericardic punction was performed in all patients, but only in four patients was nutrition admixture was obtained. Conclusions:we consider superior cava vein to be the safest site to place a central venous catheter above right atrium. lts position must periodically be confirmed via xray because of risk of migration phenomenom. Pericardic punction should be considered when a patient suddenly requires cardiopulmonary resuscitation and does not respond to common reanimation maneuvers.


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