Comparison of the complications of inter and post operation of central vein catheterization (CVC) of internal jugular vein in repaired and cut down method in neonates

Goal: to compare the complications of inter and post operation of central vein catheterization (CVC) of internal jugular vein in repaired and cut down methods in 71 Neonates under 30 days. In repair method cases were positioned in trendelenburg (30 degree) position. After fixing the head in a hyper extended position, it was turned to the left. Catheterization was done using a luminal broviac catheter (14-16 G) under anesthetic monitoring. After the local anesthesia (Lidocaine 1%) on Sternocleidomastoid (SCM) an incision (2 Cm) was made. Following the dissection of subcutaneous tissue and platysma muscle, the SCM was exposed. On the anterior Portion a space was made and internal Jugular vein below the muscle was identified. Using a silk Suture (3-0) both ends of vein was elevated. Then in the lateral Portion of the nipple (6-8 Cm from the incision) under the influence of local anesthesia a small incision was made and through a subcutaneous canal central venous canal (CVC) was moved to the neck region. Cutting on the vein, lateral side of the vein wall was opened to let the Catheter to move inside. Making an aspiration with a syringe provided the efficacy of the Catheter. The site of catheter cut was narrowed using a prolin suture (6-0) to prevent the bleeding. On termination, the Catheter was fixed on the skin and the site of catheterization was verified using a chest graphy. In cutdown method the procedure was the same with the exception that after the exposure of internal Jugular vein, at first the proximal side of the vein was ligated using a silk suture (3-0) and the Catheter was guided towards the distal lumen of internal Jugular vein and fixed on the skin.

Vice Chancellor for Research, Kashan University of Medical Sciences