# Pericardial Effusion and Cardiac Tamponade in Preterm Neonates After Umbilical Venous Catheter Insertion: Management of a Case Series Using a Point-of-Care Ultrasonography (POCUS)-Guided Clinical Protocol

## TL;DR

This paper discusses how point-of-care ultrasound can help diagnose and manage life-threatening heart complications in preterm neonates after umbilical catheter insertion.

## Contribution

The study introduces a POCUS-guided clinical protocol for managing UVC-related pericardial effusion and cardiac tamponade in neonates.

## Key findings

- POCUS enabled timely diagnosis of pericardial effusion and cardiac tamponade in neonates.
- Ultrasound-guided pericardiocentesis was successfully used to treat affected neonates.
- POCUS as part of a protocol can improve outcomes in neonates with UVC-related complications.

## Abstract

Umbilical venous catheter (UVC) insertion is a common practice of neonatal management among neonatal intensive care units (NICUs). Although rarely reported, pericardial effusion and cardiac tamponade are potentially fatal complications of UVC insertion requiring prompt medical intervention. Echocardiography, as a point-of-care ultrasound (POCUS) practice, may enable accurate diagnosis and treatment. We report four cases of pericardial effusion after UVC insertion; two of them developed cardiac tamponade, highlighting the use of POCUS as a diagnostic modality in life-threatening complications. Ultrasound-guided pericardiocentesis was performed using echocardiography as a point-of-care applied method. Fatal UVC-related complications should be considered in neonates who suddenly develop cardiovascular instability. Echocardiography as a POCUS strategy under protocol may guide monitoring and optimal management in critically ill neonates in NICUs.