[Intraoperative delayed pneumothorax after subclavian vein catheterization]

Intraoperative delayed pneumothorax occurred in five patients. It took several attempts to insert a subclavian vein catheter in four of the patients. The first chest X-ray films after the insertion of the catheter in the five patients were not indicative of pneumothorax. Pulse oximetry could detect the initial sign of pneumothorax prior to hemodynamic instability in three patients. In case of positive pressure ventilation and nitrous oxide administration for general anesthesia, this complication may be life threatening. It is necessary to take great care not to overlook intraoperative delayed pneumothorax in a patient with subclavian vein catheterization.