We report a case of cardiac tamponade following the placement of a peripherally inserted central venous catheter (PICC) in a very low birth weight infant, successfully resuscitated by emergency pericardiocentesis. The female newborn, delivered at 29 weeks' gestation via operative delivery for placenta previa, weighed 1,191 g at birth. She required ventilatory support due to prematurity but was successfully weaned within a short period. On day 6 of life, she experienced sudden circulatory collapse due to massive pericardial effusion. Given that the episode occurred several hours after PICC insertion, cardiac tamponade was suspected. Rapid ultrasound assessment confirmed the diagnosis, and immediate pericardiocentesis successfully stabilized the infant, leading to an uneventful recovery. In preterm infants with a PICC, sudden unexplained circulatory collapse should prompt immediate ultrasound evaluation and intervention, as these are critical for successful resuscitation.
