Three cases of neonatal pericardial effusion related to umbilical venous catheterization / 中华实用儿科临床杂志

A retrospective case review was conducted of 3 cases with umbilical venous catheterization(UVC) related pericardial effusions in the Neonatal Intensive Care Unit of Zhongnan Hospital of Wuhan University from December 2020 to April 2022.All 3 cases were preterm infants with gestational ages of 33 + 4, 31 and 27 + 6 weeks, respectively.UVC was inserted routinely in 24 hours after birth.Three neonates developed tachycardia or bradycardia, dyspnea, decreased oxygen saturation and muffled heart sound at the 1 st to 4 th day after catheterization.Echocardiography indicated pericardial effusion, so the 3 neonates underwent pericardiocentesis and drainage.Among the 3 neonates, 2 cases improved and have good prognosis, 1 case died.UVC can cause pericardial effusion, which occurs mostly in the early stage after catheterization.Pericardial effusion and tamponade should be considered when patients show unexplained sudden clinical deterioration after catheterization, such as dyspnea, cyanosis, tachycardia or bradycardia, etc.Once diagnosed, umbilical vein catheter should be removed in time and pericardiocentesis and drainage should be performed for decompression.Early diagnosis and intervention can effectively improve the prognosis.

Study of clincial profile and outcome of Klebsiella sepsis in neonates at a tertiary care centre

Background: Objective of the study is to study clinical profile and outcome of Klebsiella sepsis in neonates.Methods: A retrospective observational study from January 2018 to Sep 2018. After getting approval of institute ethics committee, admitted neonates whose blood culture showed Klebsiella growth were enrolled. A detailed history, birth weight, sex , age, APGAR, need for resuscitation at birth, distress at birth, ventilator support, CPAP, central line, blood products, species of Klebsiella and drug sensitivity and outcome-discharge or death were taken. Data were entered into Microsoft excel data sheet and was analyzed using SPSS 23 version software.Results: Out of the total 252 positive blood culture, 110 (43%) grew Klebsiella in blood culture. 92 cases were included in the study. Male to female ratio was 1.24:1. Mean age at admission was 1.22 days. 40 (43.5%) died and 52(56.5%) were discharged. Birth weight was 1.635'802 gm for babies who died and 2211'939 gm among discharged. Mean gestational age were 32.5 weeks in died and 34.8 weeks among discharged. Mortality was 23(57.5%) in males, low birth weight babies 23(59%), thrombocytopenia 28 (78%), invasive mode of ventilation 19(67%). By Univariate analysis, it was found that pregnancy induced hypertension (PIH), premature rupture of membrane (PROM), abnormal APGAR, Birth weight, shock, invasive ventilation, DIC, inotropes, blood products, abnormal total count, thrombocytopenia, umbilical venous catheterization were factors which influenced outcome. Regression analysis identified only thrombocytopenia and umbilical venous catheterization as factors that influenced outcome in Klebsiella sepsis. Klebsiella isolated was uniformly sensitive to Meropenam.Conclusions: No single risk factor was ascertained but thrombocytopenia and umbilical venous catheterization possibly influence the outcome of Klebsiella sepsis. Mortality is high in neonates.

A Case of Right Atrium thrombosis Caused by Umbilical Venous Catheterization

Insertion of intravascular catheters may be the most common procedure in neonatal intensive care units. One of these kinds of catheters, umbilical venous catheter is generally used for the small and sick neonates. But the indwelling umbilical venous catheter can cause many complications. The most common complication is thrombus formation in the lumen of the catheter. Neonatal thrombosis has symptomatic or asymptomatic clinical manifestations, which may have serious complications in case of intracardiac thrombosis. In our experience, the infant who has no symptom of thrombosis was treated with low dose aspirin and warfarin for right atrium thrombosis caused by umbilical venous catheterization. So, we report a case of right atrium thrombosis following umbilical catheterization in neonatal intensive care units.

Umbilical venous line-related pleural and pericardial effusion causing cardiac tamponade in a premature neonate: A case report / 소아과

Cardiac tamponade with pleural and pericardial effusion is a rare but life-threatening complication of umbilical venous catheterization in the newborn. It requires a timely diagnosis and urgent treatment, such as pericardiocentesis, to save lives of affected patients. Recently, we experienced a 7 day-old, very low birth weight infant, who developed a cardiac tamponade with pleural and pericardial effusions complicated by umbilical venous catheterization. The patient was successfully treated with pleural and pericardial drainages. Here, we report this case with a review of literature, since there has been no such previous case reported in Korea.