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Cardiac arrest in an extremely low birth weight infant: complication of percutaneous central venous catheter
P Sasidharan1, D Billman, R Heimler
1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, USA.
Insights
Sudden cardiac arrest occurred in an extremely low birth weight infant due to central venous catheter complications. Myocardial infiltration by intralipid was the likely cause, a previously unreported pathological finding.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Pathology
Background:
- Central venous catheters are essential for parenteral nutrition in extremely low birth weight infants.
- Complications associated with central venous catheter use can be serious and life-threatening.
Observation:
- An extremely low birth weight infant experienced sudden cardiac arrest on the eighth day post-central venous catheter insertion.
- The infant had been receiving parenteral nutrition via a percutaneous silicone rubber central venous catheter.
Findings:
- Autopsy revealed infiltration of the myocardium with intralipid and degeneration of myocardial fibers in the right atrium and ventricle.
- This specific pathological condition, linked to central venous catheter use, has not been previously documented.
- No pericardial effusion was noted in the infant.
Implications:
- This case highlights a rare but critical complication of central venous catheters in neonates.
- Early recognition and management of potential catheter-related complications are crucial for infant survival.
- Further investigation into intralipid-related myocardial toxicity in infants may be warranted.
Abstract:
We report a case of unexpected sudden cardiac arrest in an extremely low birth weight infant on the eighth day after a percutaneous silicone rubber central venous catheter was inserted for parenteral nutrition. The unique pathologic condition of infiltration of the myocardium with probably intralipid and degeneration of myocardial fibers over the right atrium and part of the right ventricle has not been reported in the past. There was no pericardial effusion. A brief review of the complications of central venous catheters is given.