Ali Rahmi Bakiler, Özkan İlhan, Sinem Akbay, Berat Kanar, Seyma Memur, Esra Arun Özer, Sümer Sütçüoğlu, Onur Işık

Preterm infantta katater ilişkili sepsisin neden olduğu kardiyak tamponad

Prematüre yenidoğanda kateter ilişkili sepsise bağlı kardiyak tamponad nadir görülen ve hayatı tehdit eden bir komplikasyondur. Ancak hızlı teşhis ve müdahale bu durumu tersine çevirebilir. Biz, kateterle ilişkili sepsise sekonder perikardiyal efüzyon ve kardiyak tamponad ile karşımıza çıkan dokuz günlük preterm bir bebek sunduk. Bu raporda iki önemli konu vurgulanmaktadır: periferal yerleşimli santral venöz kateteri (PICC) olan bir yenidoğanda, hiperosmolar parenteral solüsyonun bileşimi ile ilgili kanıt bulunmamasına rağmen, perikardiyal efüzyonun ortaya çıkabileceği ve sepsisin bu kritik durum için bir neden olabileceğidir.

A cardiac tamponade caused by catheter-related sepsis in a preterm infant

Cardiac tamponade due to catheter related sepsis in premature neonate is a rare and life-threateningcomplication; but prompt diagnosis and intervention can reverse this situation. We report a nine-day-oldpreterm infant who presented with pericardial effusion and cardiac tamponade secondary to catheterrelated sepsis. This report highlights two important aspects: occurrence of pericardial effusion in aneonate with peripherally inserted central venous catheter (PICC), with no evidence of composition ofhyperosmolar parenteral solution, and awareness of sepsis as a cause for this critical condition.

PDF

___

1. Warren M, Thompson KS, Popek EJ, Vogel H, Hicks J. Pericardial effusion and cardiac tamponade in neonates: sudden unexpected death associated with total parenteral nutrition via central venous catheterization. Ann Clin Lab Sci. 2013; 43 (2): 163-71.
2. Iyer VH, Sharma DM, Charki S, Mohanty PK. Cardiac tamponade in a neonate: a dreadful condition-need for functional echo. BMJ Case Rep. 2014; 1-4.
3. Cartagena AM, Levin TL, Issenberg H, Goldman HS. Pericardial effusion and cardiac hemangioma in the neonate. Pediatr Radiol. 1993; 23 (5): 384-5.
4. Pizzuti A, Parodi E, Abbondi P, Frigerio M. Cardiac tamponade and successful pericardiocentesis in an extremely low birth weight neonate with percutaneously inserted central venous line: a case report. Cases J. 2010; 3: 15.
5. Nowlen TT, Rosenthal GL, Johnson GL, Tom DJ, Vargo TA. Pericardial Effusion and Tamponade in Infants with Central Catheters. Pediatrics. 2002; 110 (1 Pt 1): 137-42.
6. Konjevıć S, Djukıć D, Stanımırovıć B, Blagojevıć A, Bobıć V, et al. Peripherally inserted central catheter complications in neonates – our experiences. -Signa Vitae. 2015; 10 (1): 16-9.
7. Borghesi A, Stronati M. Strategies for the prevention of hospital-acquired infections in the neonatal intensive care unit. J Hosp Infect. 2008; 68 (4): 293-300.
8. Ohki Y, Yoshizawa Y, Watanabe M, Kuwashima M, Morikawa A. Complications of percutaneously inserted central venous catheters in Japanese neonates. Pediatr Int. 2008; 50 (5): 636-9.
9. Lawrenz-Wolf B, Hermann B. Pericardial tamponade caused by catheter infection in an extremely small premature infant. Monatsschr Kinderheilkd. 1993; 141 (12): 932-5.
10. Durão D, Fernandes AP, Marum S, Marcelino P, Mourão L. Cardiac tamponade secondary to methicillinresistant Staphylococcus aureus pericarditis. Rev Port Cardiol. 2008; 27 (7-8): 953-8.