초극소저체중출생아에서 발생한 제대정맥도관 관련 심낭압전 1예

초록

Umbilical venous catheters (UVCs) are frequently used in extremely low birth weight (ELBW) infants for intravenous access. It is important to position correctly to prevent complications, including arrhythmia, pleural effusion, pericardial effusion, and cardiac tamponade. Pericardial effusion remains asymptomatic in the early stages and cardiac tamponade suddenly appears as a cardiac arrest. The authors report a case of successful management of malpositioned UVC-related cardiac tamponade in an ELBW infant with 23 weeks 5 days of gestation and 688 g of birth weight. He was resuscitated successfully after emergency pericardiocentesis and prompt removal of catheter. To our knowledge, it is the youngest survived case complicated by UVC-related cardiac tamponade reported in the literature. Our case confirms the necessity of the placement at a correct position of a UVC after its insertion and pericardial effusion should be suspected in sick infants with UVCs and progressive cardiomegaly. A timely diagnosis with echocardiography and pericardiocentesis may prove life-saving.

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