Pericardial Effusion and Cardiac Tamponade in Preterm Neonates After Umbilical Venous Catheter Insertion: Management of a Case Series Using a Point-of-Care Ultrasonography (POCUS)-Guided Clinical Protocol

Umbilical venous catheter (UVC) insertion is a common practice of neonatal management among neonatal intensive care units (NICUs). Although rarely reported, pericardial effusion and cardiac tamponade are potentially fatal complications of UVC insertion requiring prompt medical intervention. Echocardiography, as a point-of-care ultrasound (POCUS) practice, may enable accurate diagnosis and treatment. We report four cases of pericardial effusion after UVC insertion; two of them developed cardiac tamponade, highlighting the use of POCUS as a diagnostic modality in life-threatening complications. Ultrasound-guided pericardiocentesis was performed using echocardiography as a point-of-care applied method. Fatal UVC-related complications should be considered in neonates who suddenly develop cardiovascular instability. Echocardiography as a POCUS strategy under protocol may guide monitoring and optimal management in critically ill neonates in NICUs.