[Bronchovascular fistula--complication of percutaneous central venous catheter in a neonate]

To present a case of central venous line misplacement with vasculo-pulmonary fistula and severe respiratory consequences in a newborn. To review the literature concerning respiratory and non-respiratory complications related to the introduction of percutaneously placed central venous lines in children.

Evaluative and diagnostic data were described after patient chart review. A premature newborn was admitted in a NICU after delivery for treatment of low-grade hyaline membrane disease and infection manifested afterwards. In the day after the introduction of the percutaneously placed central venous catheter, in order to provide parenteral nutrition, respiratory distress began with rapid progression. Mechanical ventilation was demanded to establish proper gas exchange. The complication was revealed after checking the catheter course using radiographic contrast.

Complications associated with central venous catheter insertion are not rare and infection is the most frequent one. It is essential that the caretakers be aware of the many less frequent ones like vascular thrombosis and catheter misplacement with organ injury and extravascular fluids collections. Only one description related to this kind of complication verified in our patient was found in newborns. This singular characteristic may have resulted in embarrassment for rapid diagnosis. Care related aspects, after catheter insertion, that could make easier the prompt recognition of these complications are emphasized.