Central venous catheterization and fatal cardiac tamponade

Abstract
Cardiac tamponade is a poorly recognized complication of central venous catheterization associated with a high mortality. We present a case of fatal cardiac tamponade after intra- pericardial infusion of total parenteral nutrition in a patient who had two central venous catheters. We suggest that catheter tip position should always be confirmed before use of a catheter. Tamponade should be suspected in a patient who deteriorates when a central venous catheter is used and resuscitation via the catheter should be avoided.