ABSTRACT
Percutaneously inserted central venous catheters (PICC) are used in premature infants to deliver intravenous fluids, total parenteral nutrition (TPN) and medications. This article reports a case in which the baby developed pericardial tamponade within 3 hours of starting TPN through a PICC. This was successfully treated with percutaneous subxiphoid pericardiocentesis. Pericardial tamponade should be suspected in any infant with a PICC line in place, and who suddenly develops shock like symptoms, non-attributable to usual causes.
Subject(s)
Cardiac Tamponade/etiology , Catheterization, Central Venous/adverse effects , Infant, Premature , Parenteral Nutrition/adverse effects , Acute Disease , Cardiac Tamponade/diagnostic imaging , Cardiac Tamponade/therapy , Female , Follow-Up Studies , Humans , Infant, Newborn , Parenteral Nutrition/methods , Pericardiocentesis , Radiography , Risk Assessment , Treatment OutcomeABSTRACT
Over a 21-month period 200 fetal echocardiographic studies were performed on pregnancies at high risk for congenital heart disease referred to the NSW Fetal Echocardiography Service. Four cases of hypoplastic left heart syndrome were diagnosed in-utero during this period. These cases demonstrated the heterogeneity of this lesion, its known association with other defects and chromosomal anomalies, and evidence of in-utero evolution. Hypoplastic left heart syndrome is reliably diagnosed by fetal echocardiography. This lesion is heterogenous and may evolve beyond the first trimester. Careful attention to ventricular function, endocardial echoes and Doppler flow may assist with diagnosis.
