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Correspondence  |   August 2018
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Author Notes
  • General Hospital of Klagenfurt, Feschnigstrasse, Klagenfurt, Austria. breschan.ch@chello.at
  • (Accepted for publication May 7, 2018.)
    (Accepted for publication May 7, 2018.)×
Article Information
Correspondence
Correspondence   |   August 2018
In Reply
Anesthesiology 8 2018, Vol.129, 387. doi:10.1097/ALN.0000000000002286
Anesthesiology 8 2018, Vol.129, 387. doi:10.1097/ALN.0000000000002286
We want to thank Dr. Brock-Utne for his valuable contribution. Undoubtedly, pericardial effusion with ensuing tamponade is a possible complication of any central venous catheter with a high mortality.1  Peripherally inserted central venous lines may even carry a greater risk due to catheter tip migration with changes of arm position.2 
However, the purpose of our analysis was to demonstrate the relative ease and safety of supraclavicular, ultrasound-guided brachiocephalic vein cannulations in preterm infants without including any long-term complications as of yet.3  In 155 brachiocephalic venous catheters in babies less than 2.5 kg, we have not observed a pericardial effusion. The best way to avoid a pericardial effusion caused by central venous lines and other major complications is to follow, e.g., the Italian vascular access guidelines,4  which also propose the correct catheter tip position in the cavoatrial junction preferentially by the use of echocardiography or intracavitary electrocardiography.
Competing Interests
The author declares no competing interests.
Christian Breschan, M.D., Ph.D., General Hospital of Klagenfurt, Feschnigstrasse, Klagenfurt, Austria. breschan.ch@chello.at
References
Beardsall, K, White, DK, Pinto, EM, Kelsall, AW Pericardial effusion and cardiac tamponade as complications of neonatal long lines: Are they really a problem? Arch Dis Child Fetal Neonatal Ed 2003; 88:F292–5 [Article] [PubMed]
Booth, SA, Norton, B, Mulvey, DA Central venous catheterization and fatal cardiac tamponade. Br J Anaesth 2001; 87:298–302 [Article] [PubMed]
Breschan, C, Graf, G, Jost, R, Stettner, H, Feigl, G, Neuwersch, S, Stadik, C, Koestenberger, M, Likar, R A retrospective analysis of the clinical effectiveness of supraclavicular, ultrasound-guided brachiocephalic vein cannulations in preterm infants. Anesthesiology 2018; 128:38–43 [Article] [PubMed]
Open Group Study of Long-Term Central Venous Accesses (GaVeCeLT): Long-term Central Venous Accesses (translated from Italian). Available at: http://www.gavecelt.it. Accessed January 22, 2012