Mohammad Soleimani - Department of Pediatrics, Beheshti Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
Zohreh Badiee - professor of pedatrics, Isfahan University of medical sciences, Isfahan,Iran
Razieh Goudarzi - Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran

Background: Pericardial effusion and cardiac tamponade are the rare complications of peripherally inserted central catheters (PICC insertion) in extreme low birth weight infants. In this regard, paying attention to these complications is of utmost importance, because they can result in infant death. Case report: The case of our infant is a sample of these complications. On the 39th day of the birth of the infant, the muffled sounds of heart and pathological murmurs in heart auscultation raised the doubt of a problem in infant’s heart. Conclusion: In this regard, echocardiography was performed. The report was massive pericardial effusion impending tamponade. After pericardiocentesis for saving infant’s life,  diagnostic evaluations were performed, and PICC insertion was proved as the cause of these complications. Although these complications are usually diagnosed with symptoms like bradycardia, hypotension, and drop in saturation or cardiac arrest, the first step of diagnosis in our infant was abnormal heart examination. Therefore, it is essential that all neonatologists pay attention to heart examination of infants with PICC along with other symptoms such as bradycardia, hypotension, and drop in saturation or cardiac arrest to avoid occurring pericardial effusion and cardiac tamponade as rare complications of PICC insertion. They should consider pericardial effusion and cardiac tamponade as the fatal complications of PICC insertion in extremely low birth weight infants with PICC.

Cardiac Tamponade, Extremely low birth weight infant, Pericardial Effusion, PICC insertion