Trendelenburg position
Fluid responsiveness was defined as ΔVTI of 15% or more, after volume expansion. Hemodynamic parameters were recorded at each step. The protocol included four sequential steps: (1) baseline-1, a supine position with a 15° upward bed angulation (2) Trendelenburg maneuver, 15° downward bed angulation (3) baseline-2, the same position as baseline-1, and (4) fluid challenge, administration of 500 mL gelatin over 15 min without postural change. This prospective study was conducted in patients with VA-ECMO support. The aim of this study was to investigate whether changes in left ventricular outflow tract velocity–time integral (ΔVTI), induced by a Trendelenburg maneuver, could predict fluid responsiveness during VA-ECMO. J Craniomaxillofac Surg 2001 29: 214–8.Evaluation of fluid responsiveness during veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support is crucial.
Trendelenburg position for free#
The effect of head rotation on the diameter of the internal jugular vein: implications for free tissue transfer. Muhammad JK, Pugh ND, Boden L, Crean SJ, Fardy MJ. The effect of position and different manoeuvres on internal jugular vein diameter size. Crit Care Med 1991 19: 1516–9.Īrmstrong PJ, Sutherland R, Scott DH. Anatomical variations of internal jugular vein location: impact on central venous access. A sonographically guided technique for central venous access. Teichgraber UK, Benter T, Gebel M, Manns MP. Use of ultrasound to place central lines. Ultrasound-facilitated central venous cannulation. Ultrasound monitoring in cannulation of the internal jugular vein: anatomic and technical considerations. Am J Roentgenol 1998 171: 1259–63.ĭocktor B, So CB, Saliken JC, Gray RR. Sonographic guidance when using the right internal jugular vein for central vein access. J Vasc Interv Radiol 1998 9: 333–8.Ĭaridi JG, Hawkins IF Jr, Wiechmann BN, Pevarski DJ, Tonkin JC. US-guided puncture of the internal jugular vein: complications and anatomic considerations.
Gordon AC, Saliken JC, Johns D, Owen R, Gray RR. La position du patient qui permet d’obtenir le diamètre maximal de la JID pour la mise en place d’une canule est: la position de Trendelenburg avec une inclinaison de 15° un petit coussin ou un anneau lesté sous la tête la tête dans un plan médian ou s’en approchant après la palpation de l’artère carotide, toute pression cessée avant l’introduction d’une canule.
Trendelenburg position plus#
En position de Trendelenburg (inclinaison de 15°), un coussin sous la tête l’augmentait encore plus (13,3 ± 2,26 mm, P < 0,001), la palpation de l’artère carotide le diminue (8,2 ± 1,98 mm, P < 0,001) et la rotation de la tête de 45° vers la gauche ne le réduit pas de façon significative (11,7 ± 2,52 mm, P = 0,12). Une inclinaison de Trendelenburg de 15° l’augmentait aussi (12,1 ± 2,34 mm, P < 0,001). Un petit coussin sous la tête augmentait le diamètre de la JID (10,6 ± 2,16 mm, P < 0,001). RésultatsĮn position neutre (à plat, tête sur la table dans un plan médian) le diamètre de la JID était de (moyenne ± écart type) 9,2 ± 2,18 mm. L’échographie 2D a été utilisé pour mesurer le diamètre de la JID selon diverses positions du corps chez 21 volontaires en bonne santé. L’objectif de notre étude était de déterminer la position du patient qui favorise le diamètre maximal de la veine JID. La veine jugulaire interne droite (JID) est couramment utilisée comme accès veineux et le succès de la mise en place d’une canule montre une corrélation positive avec le diamètre de la veine.
The patient position to achieve maximal RIJ diameter cannulation is: 15° of Trendelenburg tilt a small pillow or head ring under the head the head in or close to midline and after palpation of the carotid artery, it should be released prior to vein cannulation. In the Trendelenburg position (15° of tilt), a small pillow under the head further increased RIJ diameter (13.3 ± 2.26, mm P < 0.001), palpating for the carotid artery decreased RIJ diameter (8.2 ± 1.98 mm, P < 0.001), and rotation of the head 45° to the left did not reduce RIJ diameter significantly (1 1.7 ± 2.52 mm, P = 0.12). Trendelenburg tilt of 15° increased RIJ diameter (12.1 ± 2.34 mm, P < 0.001). A small pillow under the head increased RIJ diameter (10.6 ± 2.16 mm, P < 0.001).
In the neutral position (table flat, head on the table in midline) the RIJ diameter was (mean ± standard deviation) 9.2 ± 2.18 mm. MethodĢD ultrasound was used to measure RIJ diameter, in varying body positions, in 21 healthy volunteers. The purpose of this study is to establish the patient position resulting in the largest RIJ diameter. The right internal jugular (RIJ) is commonly used to provide central venous access, and success of cannulation shows a positive correlation with the vein’s diameter.