Subclavian Vein Cannulation Success or Failure in Neonates and Children

Background: Central vein cannulation (CVC) allows administration of large volumes of fluids in short times and at high osmolaritiy for rehydration, volume replacement, chemotherapy and parenteral nutrition. Percutaneous central venous line insertion has replaced peripheral venous cut-down as the primary mode of short term venous access in children. Materials and Methods: 3264 subclavian vein cannulations in neonates and children were analyzed regarding successful attempt for catheterization and early complication rates after the procedure retrospectively. Results: We had 1340 newborn patients (first 28 days of life) in our study population. In this group, only 55cannulations were failed, 1 patient were complicated with pneumothorax, in 21 cases guide wires became malfunction and only in 981 cases attempts to cannulation were successful in first attempt. In the remaining 1924 patients, 1 month to 8 years old, only 14 attempts to cannulation of subclavian vein was failed and in 1655 cases cannulation performed successfully at first attempt. CVC success rate was significantly higher in children older than 1 month compare to less than 1 month age (P=0.03). Conclusions: Cannulation of central vein in neonates and children in a skilled hand would be performed with great success rate and low complications but in neonates less than 1 month age it has higher failure rate.