Beating the scarcity by using a central venous catheter for pericardiocentesis in neonates: A case report

Background: A peripherally inserted central catheter (PICC) is commonly used in the neonatal intensive care unit (NICU). Although beneficial, PICC can result in deadly silent complications, namely pericardial effusion and cardiac tamponade, requiring urgent pericardiocentesis. In this case, a central venous catheter (CVC) was used in the pericardiocentesis procedure due to the inadequacy of the standard catheter. Case presentation: A female neonate with a birth weight of 920 grams and 29-week gestational age has been admitted to the NICU since she was born. On her 29th day of life, the patient suddenly became tachycardic and has frequent apnea episodes. Babygram showed the tip of the PICC was in the right atrium. Echocardiography revealed massive pericardial effusion. Pericardiocentesis was performed bedside using a 3Fr CVC due to the limited availability of pigtail catheters suitable for neonates. Immediately after the pericardiocentesis, the patients became stable with a normal heart rate and no episodes of apnea. Conclusion: Pericardial effusion is a rare complication of PICC, but it is associated with high mortality. The use of CVC for pericardiocentesis under echocardiography guidance in settings with limited facilities can be an option for this life-saving procedure.