Frequency Of Immediate Pneumothorax After Subclavian Venous Cannulation

Abstract

Objective: To determine the frequency of immediate pneumothorax after subclavian venous
cannulation.
Material and Methods: This clinical trial was carried out in Mayo Hospital in all four medical
ward (East, West, North, and South) and Nephrology ward of Mayo Hospital, Lahore during the
period from15th March 2013 to 15th September 2013. It was descriptive case series study. A total
of 450 cases fulfilling inclusion and exclusion criteria attending in patient department were
selected. After antiseptic preparation of field, local anesthesia was administered. The subclavian
vein was punctured at the junction between the middle and inner thirds of the clavicle. Negative
pressure was maintained in the syringe to facilitate blood return when the subclavian vein was
entered. A J guide-wire was advanced through the cannula to a length of 20 (15-16) cm. A small
skin incision was placed at this site for ease of catheter passage. After dilatation, a catheter was
inserted and advanced to predetermined point over the guide-wire. The lumen of catheter was
sutured to avoid intra cardiac tip displacement and to prevent kinking and accidental withdrawal.
Pneumothorax was checked by Chest X-ray taken within four hours of procedure.
Results: In our study, 41.56%(n=187)patients were between 30-50 years while 58.44%(n=263)
were between 51-70 years, Mean+SD was calculated as 51.92 ±11.23 years, 57.56%(n=259)
male and 42.44%(n=191) were females, frequency of immediate pneumothorax after subclavian
venous cannulation was 6.44%(n=29) while 93.56%(n=421) had no findings of the such
complications.
Conclusion: We concluded that the frequency of immediate pneumothorax among patients
with subclavian venous cannulation is in agreement with other studies and not very high. But it is
recommended that every patient who undergo with subclavian venous cannulation should be
sorted out for pneumothorax. However, it is also required that every setup should have its
surveillance in order to know the frequency of this complication