Journal article
Trendelenburg position does not increase cross-sectional area of the internal jugular vein predictably
Chest, Vol.144(1), pp.177-182
07/2013
DOI: 10.1378/chest.11-2462
PMID: 23392444
Abstract
The Trendelenburg position is used to distend the central veins, improving both the success and safety of vascular cannulation. The purpose of this study was to measure the cross-sectional area (CSA) of the internal jugular vein (IJV) in three different positions using surface ultrasonography.
Fifty-one subjects were enrolled. A Sono Site Titan 180 or M-Turbo portable ultrasound machine with a 10.5-mHz broadband linear surface probe was used. We measured the CSA of the IJV (at end-expiration at the level of the cricoid cartilage) in three positions: 15° reverse Trendelenburg, supine, and 15° Trendelenburg.
The mean CSA at 15° reverse Trendelenburg was 0.83 cm2 (SD, 0.86), in the supine position it was 1.25 cm2 (SD, 0.98), and at -15° Trendelenburg it was 1.47 cm2 (SD, 1.03). Moving from reverse Trendelenburg to supine, the CSA increased by 50%. In contrast, lowering the head to a Trendelenburg position increased the mean CSA by only 17%. Surprisingly, Trendelenburg positioning reduced the CSA in nine of the 51 subjects.
Trendelenburg positioning augments the CSA only modestly, on average, compared with the supine position, and in some patients it reduces the CSA.
ClinicalTrials.gov; No.: NCT01099254; URL: www.clinicaltrials.gov.
Details
- Title: Subtitle
- Trendelenburg position does not increase cross-sectional area of the internal jugular vein predictably
- Creators
- Boulos Nassar - Division of Pulmonary Diseases, Critical Care, and Occupational Medicine, Department of Internal Medicine, University of Iowa, Iowa City, IAGur Raj S Deol - Division of Pulmonary Diseases, Critical Care, and Occupational Medicine, Department of Internal Medicine, University of Iowa, Iowa City, IAAndrew Ashby - Division of Pulmonary Diseases, Critical Care, and Occupational Medicine, Department of Internal Medicine, University of Iowa, Iowa City, IANicole Collett - Division of Pulmonary Diseases, Critical Care, and Occupational Medicine, Department of Internal Medicine, University of Iowa, Iowa City, IAGregory A Schmidt - Division of Pulmonary Diseases, Critical Care, and Occupational Medicine, Department of Internal Medicine, University of Iowa, Iowa City, IA. Electronic address: Gregory-a-schmidt@uiowa.edu
- Resource Type
- Journal article
- Publication Details
- Chest, Vol.144(1), pp.177-182
- DOI
- 10.1378/chest.11-2462
- PMID
- 23392444
- ISSN
- 0012-3692
- eISSN
- 1931-3543
- Language
- English
- Date published
- 07/2013
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984094730202771
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