Paladini Angela, D'Andrea Vito, Bottoni Anthea, Purcaro Velia, Prontera Giorgia, Costa Simonetta, Vento Giovanni
U.O.C. di Neonatologia, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, Rome, Italy.
J Matern Fetal Neonatal Med. 2023 Dec;36(1):2212831. doi: 10.1080/14767058.2023.2212831.
Pericardial effusion (PE) in pediatric population can be asymptomatic or a life-threatening event. Reports on neonates or preterm infants are scarce and generally related to pericardiocentesis of large amounts of PE in emergency situations.We describe a diagnostic pericardiocentesis in a preterm infant with small and loculated pericardial effusion and suspected cardiac mass. We used an ultrasound-guided long-axis in-plane pericardiocentesis technique, with a needle-cannula. The operator obtained a subxiphoid pericardial effusion view with a high frequency linear probe and entered the skin below the tip of the xiphoid process with a 20-gauge closed IV needle-cannula (ViaValve®). The needle was identified in its entirety as it courses through soft tissue up to pericardial sac. The main advantages of this approach are a continuous viewing and angulation of the needle through all planes of the tissue and the use of a small, practical, closed IV needle-cannula with blood control septum to prevent fluid exposure while disconnecting the syringe. This novel approach is easy and safe in neonatal population, for diagnostic or emergency drainages and can be performed at bedside in a neonatal intensive care unit.
小儿心包积液（PE）可能无症状，也可能是危及生命的事件。关于新生儿或早产儿的报道很少，且通常与紧急情况下大量心包积液的心包穿刺术有关。我们描述了一例早产儿时诊断性心包穿刺术，该患儿心包积液量少且呈局限性，怀疑有心脏肿物。我们采用超声引导下长轴平面内心包穿刺技术，使用穿刺针套管。操作者用高频线性探头获得剑突下心包积液图像，并用20号封闭式静脉穿刺针套管（ViaValve®）在剑突尖下方进针。当穿刺针穿过软组织直至心包腔时，可全程清晰显示。这种方法的主要优点是在组织的所有平面上都能持续观察穿刺针并进行角度调整，且使用小型、实用的带血液控制隔膜的封闭式静脉穿刺针套管，在断开注射器时可防止液体暴露。这种新方法在新生儿群体中进行诊断性或紧急引流既简便又安全，可在新生儿重症监护病房的床边进行。
