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CC BY-NC-ND 4.0 · AJP Rep 2017; 07(02): e65-e67
DOI: 10.1055/s-0037-1601566
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Rare Complication of Central Venous Catheter Extravasation in a Preterm Neonate: Hemidiaphragmatic Paralysis

C. Hobson
1   University François Rabelais, Faculty of Medecine, Tours, France
2   Neonatal and Pediatric Intensive Care Unit, Hôpital Clocheville, Tours, France
,
D. Dubillot
1   University François Rabelais, Faculty of Medecine, Tours, France
2   Neonatal and Pediatric Intensive Care Unit, Hôpital Clocheville, Tours, France
,
H. Lardy
1   University François Rabelais, Faculty of Medecine, Tours, France
3   Pediatric Surgery Department, Hôpital Clocheville, Tours, France
,
D. Sirinelli
1   University François Rabelais, Faculty of Medecine, Tours, France
4   Pediatric Radiology Department, Hôpital Clocheville, Tours, France
,
E. Saliba
1   University François Rabelais, Faculty of Medecine, Tours, France
2   Neonatal and Pediatric Intensive Care Unit, Hôpital Clocheville, Tours, France
,
E. Lopez
2   Neonatal and Pediatric Intensive Care Unit, Hôpital Clocheville, Tours, France
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Publikationsverlauf

14. Oktober 2016

22. Februar 2017

Publikationsdatum:
11. April 2017 (online)

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Abstract

We report a case of a preterm neonate born at 26 weeks' of gestation diagnosed with unilateral diaphragmatic paralysis. This paralysis was a consequence of a phrenic nerve injury due to extravasation of hyperosmolar parenteral nutrition fluid in the upper thorax. Chest X-rays and ultrasonography confirmed the diagnosis. The neonate was treated with prolonged respiratory support and did not require surgical treatment. This report describes a case of hemidiaphragmatic paralysis as a complication of central venous catheter insertion. In neonates, spontaneous recovery of diaphragmatic paralysis is possible. This study concludes that recovery of extravasation injury-induced phrenic nerve palsy in the context of conservative management is possible.

Keywords

diaphragmatic paralysis - neonate - central venous catheter - diaphragmatic plication
 

  • References

  • 1 Vest JV, Pereira MB, Senior RM. Phrenic nerve injury associated with venipuncture of the internal jugular vein. Chest 1980; 78 (05) 777-779
    CrossrefPubMedSuche in Google Scholar
  • 2 Bowman ED, Murton LJ. A case of neonatal bilateral diaphragmatic paralysis requiring surgery. Aust Paediatr J 1984; 20 (04) 331-332
    PubMedSuche in Google Scholar
  • 3 Tosello B, Michel F, Merrot T. , et al. Hemidiaphragmatic paralysis in preterm neonates: a rare complication of peripherally inserted central catheter extravasation. J Pediatr Surg 2011; 46 (07) E17-E21
    PubMedSuche in Google Scholar
  • 4 Blazer S, Hemli JA, Sujov PO, Braun J. Neonatal bilateral diaphragmatic paralysis caused by brain stem haemorrhage. Arch Dis Child 1989; 64 (1 Spec No): 50-52
    CrossrefPubMedSuche in Google Scholar
  • 5 Pollard BJ, Hain WR, Small PG. Paralysis of the right hemidiaphragm. Anaesthesia 1982; 37 (02) 195-200
    CrossrefPubMedSuche in Google Scholar
  • 6 Williams JH, Hunter JE, Kanto Jr WP. Bhatia J. Hemidiaphragmatic paralysis as a complication of central venous catheterization in a neonate. J Perinatol 1995; 15 (05) 386-388
    PubMedSuche in Google Scholar
  • 7 Aggarwal S, Hari P, Bagga A, Mehta SN. Phrenic nerve palsy: a rare complication of indwelling subclavian vein catheter. Pediatr Nephrol 2000; 14 (03) 203-204
    CrossrefPubMedSuche in Google Scholar
  • 8 Ozdemir R, Oğuz S, Uras N. , et al. Phrenic nerve injury due to thoracentesis for TPN effusion in a preterm newborn: consecutive two unusual complications. Tuberk Toraks 2011; 59 (04) 384-387
    CrossrefPubMedSuche in Google Scholar
  • 9 Hannon MG, Lee SK. Extravasation injuries. J Hand Surg Am 2011; 36 (12) 2060-2065 , quiz 2066
    CrossrefPubMedSuche in Google Scholar
  • 10 O'Donnell CPF, Morley CJ. Paralyzed right hemidiaphragm in a newborn infant. J Pediatr 2006; 149 (05) 730
    CrossrefPubMedSuche in Google Scholar
  • 11 Gottesman E, McCool FD. Ultrasound evaluation of the paralyzed diaphragm. Am J Respir Crit Care Med 1997; 155 (05) 1570-1574
    CrossrefPubMedSuche in Google Scholar
  • 12 Matamis D, Soilemezi E, Tsagourias M. , et al. Sonographic evaluation of the diaphragm in critically ill patients. Technique and clinical applications. Intensive Care Med 2013; 39 (05) 801-810
    CrossrefPubMedSuche in Google Scholar
  • 13 Ribet M, Linder JL. Plication of the diaphragm for unilateral eventration or paralysis. Eur J Cardiothorac Surg 1992; 6 (07) 357-360
    CrossrefPubMedSuche in Google Scholar
  • 14 Ahmadpour-Kacho M, Zahedpasha Y, Hadipoor A, Akbarian-Rad Z. Early surgical intervention for diaphragmatic paralysis in a neonate; report of a case and literature review. Iran J Pediatr 2011; 21 (01) 116-120
    PubMedSuche in Google Scholar