RESUMEN
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