Diagnosis of cardiac tamponade in neonatal cardiopulmonar arrest using point-of-care ultrasonography: case report

Abstract

Introduction: Following the advances in medicine, ultrasound at the bedside (point-of-care ultrasound) has become a fundamental part of emergency medical assistance and emergency. The safety and ease of this exam make it a valuable tool to provide information in real time, helping to interpret signs and symptoms and, consequently, to make the diagnosis faster and more accurate. In the pediatric intensive care area, the point-of-care USG can be even more relevant, especially when it comes to the investigation of acute conditions, such as cases of neonatal cardiopulmonary arrest. Objective: To report a case of cardiorespiratory arrest due to cardiac tamponade in a pediatric patient and to highlight the importance of point-of-care ultrasonography in the diagnostic and therapeutic process of the case. Case Report: Premature newborn, female, born at 26 weeks and admitted to the Intensive Care Unit for support. The patient evolved with apnea and hemodynamic instability and subsequent cardiorespiratory arrest. In the diagnostic process, the main causes of cardiorespiratory arrest were investigated according to the American Heart Association's Pediatric Advanced Life Support protocol. After analyzing the symptoms and the patient's evolution, one of the main hypotheses suggested was cardiac tamponade, whose definitive diagnosis was made by means of point-of-care ultrasonography. Conclusion: Point-of-care ultrasonography has proved to be extremely important as it allows for a quick and accurate diagnosis, in addition to allowing adequate treatment and complete reversal of the patient's clinical condition. In addition, this test was able to show the probable cause of cardiac tamponade, revealing an intracardiac perforation possibly caused by the peripherally inserted central catheter used in the patient.