Key result
Percutaneously inserted central lines can cause pericardial effusion and cardiac tamponade, a rare complication with an incidence of 1.8/1000 lines and mortality varying from 45% to 67%.
Case Report (n=1)
Bedside echocardiography is crucial for the early diagnosis and lifesaving management of rare but highly fatal pericardial effusion and cardiac tamponade following PICL insertion in neonates.
Raises awareness for tamponade after neonatal central lines; leaves open need for prospective incidence and prevention studies.
Percutaneously inserted central lines (PICLs) are routinely used in Neonatal Intensive Care Units for even the tiniest of babies, to provide medications and parenteral nutrition. This procedure has been associated with many complications, of which pericardial effusion (PCE) and cardiac tamponade are rare. The incidence of this complication is 1.8/1000 lines and case fatality rate of 0.7/1000 lines. Others have reported an incidence in the range of 0.76%-1.8%. The mortality rate may vary from 45% to 67%. Hence, even though rare, this particular complication carries a high degree of mortality and morbidity. The purpose of this report is to sensitize the clinicians to this fatal complication; to have a high degree of suspicion for this, especially in a baby with PICL line who suddenly deteriorates or has cardiopulmonary instability. In addition, emphasized here is how a bedside basic echocardiography can be diagnostic and lifesaving for these babies.
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Desai et al. (2017) conducted a case report in Pericardial effusion and cardiac tamponade (n=1). Percutaneously inserted central line (PICL) was evaluated. Percutaneously inserted central lines can cause pericardial effusion and cardiac tamponade, a rare complication with an incidence of 1.8/1000 lines and mortality varying from 45% to 67%.
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