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Cardiac tamponade in 4010g neonate



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No. 10
Old Nov 26, 2002, 10:12 AM

THe UVC(umbilical vein cath?)was put in as soon as he was transfered to the NICU from the delivery room. To make matters worse I lost~2000cc of blood and passed out.The next day(I was in a wheelchair as they were not letting me out of bed) they told us that he was doing very well (almost on room air)one min. and then the next min. he was not breathing/blue and they called the code, then the CPR for 35 min. Sometime during the course of the CPR the found the fluid. They never gave us any explanation for the whole scenario. But I am pleased to say that he is scoring 3-4 months ahead of his age in the cognitive and motor skills
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No. 11
Old Dec 04, 2002, 12:14 PM

I have seen this only once it was in a baby with an umbilical line. In this case it was clear that the cause of the cardiac tamponade was the long line as the fluid from it was milky white and obviously lipid that the baby had been recieving.

Although there are other causes of cardiac tamponade the way you talk of "fluid rather than "blood" or "puss" mades me wouder

I expect most units have similar policies on their insertion and care but here are ours. Umbilical (long) lines ideally sit in a large vein and preferably just outside the heart.

We use them in babies that are likely to need long term fluid therapy (particularly very preterm infants) as they last longer than ordinary canulas need fewer changes so cause less trauma to the baby. Initially they are inserted into the umbilicus because it is less traumatic for the baby, later into a vein in the leg or arm.

They have two major risks, infection is the most common and we are ultra careful changing fluids etc to try and prevent this. The 2nd is that they puncture the heart or pulmonary artery, we try to prevent this with the position (as I said just out side the heart not in it) and this is checked by an xray just after insertion to insure it's correct position. BUT sometimes they move the flow of blood seems to straighten the lines and very occasionally the tip flows into the heart this is quite rare I have worked in intensive care for 8 years and only seen it once.

I hope you and your little one are doing well now
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