Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perinatal/Neonatal Casebook
  • Published:

Perinatal/Neonatal Case Book

Unexpected Resistance to External Cardiac Compression may Signal Pericardial Tamponade

Journal of Perinatology volume 22, pages 679–681 (2002)Cite this article

Abstract

Pericardial tamponade associated with central catheters is often lethal, unless promptly identified. We report our experience with two infants who suffered this complication but were successfully resuscitated. In each case, associated radiographs showed the tip of the central catheter beyond the superior vena cava–right atrium (SVC–RA) junction. Identifying the clinical triad of (1) sudden cardiovascular collapse unresponsive to usual resuscitative measures, (2) thoracic transillumination not suggestive of air leak, and (3) unexpected resistance to external cardiac compression led to the working diagnosis of pericardial tamponade and therapeutic pericardiocentesis. Prompt recovery followed. Central catheters within the RA seem prone to cause pericardial tamponade.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Hogan MJ . Neonatal vascular catheters and their complications Radiol Clin North Am 1999 37: 1109–25

    Article  CAS  Google Scholar 

  2. Leipala JA, Petaja J, Fellman V . Perforation complications of percutaneous central venous catheters in very low birth weight infants J Paediatr Child Health 2001 37: 2 168–71

    Article  CAS  Google Scholar 

  3. Rogers BB, Berns SD, Maynard EC, Hansen TW . Pericardial tamponade secondary to central venous catheterization and hyperalimentation in a very low birth weight infant Pediatr Pathol 1990 10: 5 819–23

    Article  CAS  Google Scholar 

  4. Gad Bar-Joseph, Galvis AG . Perforation of heart by central venous catheters in infants: guidelines to diagnosis and management J Pediatr Surg 1983 18: 3 284–7

    Article  Google Scholar 

  5. Goutail-Flaud MF, Sfez M, Berg A et al. Central venous catheter–related complications in newborns and infants: a 587-case survey J Pediatr Surg 1991 26: 6 645–50

    Article  CAS  Google Scholar 

  6. Nadroo AM, Lin J, Green RS, Magid MS, Holzman IR . Death as a complication of peripheral inserted central catheters in neonates J Pediatr 2001 138: 599–601

    Article  CAS  Google Scholar 

  7. Opitz JC, Toyama W . Cardiac tamponade from central venous catheterization: two cases in premature infants with survival Pediatrics 1982 70: 1 139–40

    CAS  PubMed  Google Scholar 

  8. Beattie PG, Kuschel CA, Harding JE . Pericardial effusion complicating a percutaneous central venous line in a neonate Acta Paediatr 1993 82: 105–107

    Article  CAS  Google Scholar 

  9. Wirrell EC, Pelausa EO, Allen AC, Stinson DA, Hanna BD . Massive pericardial effusion as a cause for sudden deterioration of a very low birth weight infant Am J Perinatol 1993 10: 6 419–23

    Article  CAS  Google Scholar 

  10. Fioravanti J, Buzzard CJ, Harris JP . Pericardial effusion and tamponade as a result of percutaneous silastic catheter use Neonatal Netw 1998 17: 5 39–42

    CAS  PubMed  Google Scholar 

  11. Jacobson Z, Strom J . Pericardial tamponade complicating central venous catheterization in an infant with very low birth weight: the role of echocardiography in diagnosis and treatment Heart Dis 1999 1: 3 133–5

    CAS  PubMed  Google Scholar 

  12. Kabra NS, Kluckow MR . Survival after an acute pericardial tamponade as a result of percutaneous inserted central venous catheter in preterm neonate Indian Pediatr 2001 68: 7 677–80

    Article  CAS  Google Scholar 

  13. Van Ditzhuyzen O, Ronayette D . Cardiac tamponade after central venous catheterization in a newborn infant Arch Pediatr 1996 3: 5 463–5

    Article  CAS  Google Scholar 

  14. Scharf J, Rey M, Schmiedl N, Stehr K . Pericardial tamponade as a complication of the use of peripheral percutaneous silastic catheters Klin Padiatr 1990 202: 57–9

    Article  CAS  Google Scholar 

  15. Aiken G, Porteous L, Tracy M, Richardson V . Cardiac tamponade from a fine silastic central venous catheter in a premature infant J Paediatr Child Health 1992 28: 325–7

    Article  CAS  Google Scholar 

  16. Keeney SE, Richardson CJ . Extravascular extravasation of fluid as a complication of central venous lines in the neonate J Perinatol 1995 15: 284–8

    CAS  PubMed  Google Scholar 

  17. Bargy F, Barbet P, Houette G . The pericardium of the newborn infant. Anatomic and radio-anatomic study with the view towards better positioning central catheters in the superior vena cava Bull Assoc Anat (Nancy) 1986 70: 47–9

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology, Albany Medical College, 47 New Scotland Avenue, Albany, NY, USA

    Joseph Schulman MD, MS, Upender K Munshi MD & Michelle L Eastman MS, RNC, NNP

  2. Department of Pediatrics, Division of Pediatric Cardiology, Albany Medical College, 47 New Scotland Avenue, Albany, NY, USA

    Matthew Farina MD

Authors
  1. Joseph Schulman MD, MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Upender K Munshi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michelle L Eastman MS, RNC, NNP
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Matthew Farina MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schulman, J., Munshi, U., Eastman, M. et al. Unexpected Resistance to External Cardiac Compression may Signal Pericardial Tamponade. J Perinatol 22, 679–681 (2002). https://doi.org/10.1038/sj.jp.7210815

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7210815

This article is cited by

Search

Advanced search

Quick links