Bilateral pleural effusion complicating umbilical venous catheterization

Umbilical venous lines are sometimes complicated with pleural and or pericardial effusion, often due to line migration.

Bilateral chylous pleural effusion without pericardial effusion in a 28 weeks, extremely low birth infant who was on total parenteral nutrition.

Investigations including chest x ray and 2D echocardiogram showed bilateral chylous pleural effusions but appropriate tip position of the umbilical venous line.

Removal of the umbilical venous line and cessation of total parenteral nutrition resulted in complete resolution of the pleural effusion.

In any newborn with central venous catheter in situ, acute deteriorations specially, those related to pleural and pericardial effusions should alert the clinicians to remove the catheter and should not be misguided by apparently appearing normal correct catheter position by x-ray or 2D echocardiogram.