Cardiac tamponade is a well-recognized complication of cardiac catheterization. It is also a known complication of central venous catheters that have been inserted for nutritional as well as other purposes.1-8 Dudrick et al9 first documented the clinical application of total parenteral nutrition and, since that description, hyperalimentation has been used with increasing frequency.

This paper describes two infants of very low birth weight who survived after developing pericardial tamponade caused by perforation by a central venous catheter. To our knowledge, only two premature infants are reported to have survived this complication. When rapid deterioration is noted in any infant with a central venous catheter in place, this perforation must be rapidly considered in the differential diagnosis.

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