School of Medicine, University of Electronic Science and Technology, Chengdu, China.
Department of Pediatrics, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, China.
Medicine (Baltimore). 2023 Oct 27;102(43):e35779. doi: 10.1097/MD.0000000000035779.
Peripherally inserted central catheter (PICC)-related pericardial effusion/cardiac tamponade is a rare but fatal complication which cause a high mortality if not timely diagnosed and treated. However, the atypical manifestations and the rapid deterioration present challenges for neonatologists, and there has been limited investigation reported globally to date. Furthermore, a systematic review and comprehensive summary of clinical management are lacking. The significance of this article lies in emphasizing the importance of maintaining vigilance in high-risk neonates and implementing effective management strategies for PICC-related pericardial effusion/cardiac tamponade, thereby contributing to saving more lives.
In the current report, we discuss 2 cases of neonatal pericardial effusion/cardiac tamponade following PICC catheterization.
The first case was diagnosed based on forensic autopsy and the second case was diagnosed by bedside echocardiography.
The first case was treated conservatively and the second case underwent pericardiocentesis, unfortunately both were died.
Once sudden hemodynamic or respiratory abnormalities are detected in neonates with PICC placement, particularly in the preterm infants, prompt diagnosis by cardiac ultrasound is required to verify pericardial effusion/cardiac tamponade and immediate pericardiocentesis or pericardiotomy is necessary to improve survival.
经外周静脉穿刺中心静脉置管（PICC）相关性的心包积液/心脏压塞是一种罕见但致命的并发症，如果不能及时诊断和治疗，会导致很高的死亡率。然而，其不典型的表现和迅速恶化给新生儿科医生带来了挑战，目前全球对此类疾病的报道有限。此外，还缺乏对其临床管理的系统回顾和综合总结。本文的意义在于强调在高危新生儿中保持警惕的重要性，并实施有效的 PICC 相关性心包积液/心脏压塞管理策略，从而挽救更多生命。
在本报告中，我们讨论了 2 例新生儿 PICC 置管后发生的心包积液/心脏压塞病例。
第 1 例根据法医尸检诊断，第 2 例通过床边超声心动图诊断。
第 1 例采用保守治疗，第 2 例进行了心包穿刺，但均不幸死亡。
一旦发现 PICC 置管的新生儿出现突然的血液动力学或呼吸异常，特别是早产儿，应立即通过心脏超声进行诊断以验证心包积液/心脏压塞，并立即进行心包穿刺或切开术以提高生存率。
