Pericardial Effusion and Cardiac Tamponade in Neonatal Emergencies: Sudden Death Linked to TPN via Central Venous Catheterization — A Multidisciplinary Perspective Involving Radiology, Clinical Nutrition, Pharmacy, and Nursing
Bibliographic record
Abstract
Pericardial effusion (PE) and cardiac tamponade (CT) are rare but potentially fatal complications in neonates receiving total parenteral nutrition (TPN) via central venous catheterization (CVC). These events are often linked to catheter tip malposition or migration, coupled with the chemical toxicity of hyperosmolar TPN solutions.This narrative review explores the pathophysiology, clinical presentation, diagnostic challenges, and multidisciplinary management of TPN-related PE/CT in neonates.We reviewed case reports, clinical studies, and meta-analyses published between 2013 and 2023, focusing on emergency medicine, radiology, nutrition, pharmacy, and nursing roles. Tables were included to summarize reported cases, discipline-specific findings, and research insights.Findings highlight the critical importance of point-of-care ultrasound (POCUS) in early diagnosis and catheter tip verification. Successful outcomes are associated with timely pericardiocentesis, vigilant nursing observation, and safe TPN formulation. Multidisciplinary safety protocols and routine imaging significantly reduce morbidity and mortality.Preventing neonatal cardiac tamponade requires a collaborative approach, involving accurate catheter placement, real-time monitoring, and prompt multidisciplinary response. Routine POCUS and cross-disciplinary vigilance are essential to improving outcomes in neonatal intensive care units.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".