Effect of Trendelenburg position on right and left internal jugular vein cross-sectional area

Lee, Jeong Gil; Park, Hee Bin; Shin, Hye Young; Kim, Ju Deok; Yu, Soo Bong; Kim, Doo Sik; Ryu, Sie Jeong; Kim, Gyeong Han

doi:10.4097/kjae.2014.67.5.305

Cited by 14 publications

(15 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Internal jugular vein catheterization is easy and complications are decreased when cross-sectional area is increased. 14 – 16 Various methods have been attempted to achieve cross-sectional area expansion. The Trendelenburg position is the most preferred because it increases venous return and IJV diameter.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Trendelenburg position versus upper-limb tourniquet on internal jugular vein diameter

Karaaslan

Gökay

Karakaya

et al. 2017

Annals of Saudi Medicine

View full text Add to dashboard Cite

BACKGROUNDCentral venous cannulation is a necessary invasive procedure for fluid management, haemodynamic monitoring and vasoactive drug therapy. The right internal jugular vein (RIJV) is the preferred site. Enlargement of the jugular vein area facilitates catheterization and reduces complication rates. Common methods to enlarge the RIJV cross-sectional area are the Trendelenburg position and the Valsalva maneuver.OBJECTIVECompare the Trendelenburg position with upper-extremity venous return blockage using the tourniquet technique.DESIGNProspective clinical study.SETTINGUniversity hospital.SUBJECTS AND METHODSHealthy adult volunteers (American Society of Anesthesiologists class I) aged 18–45 years were included in the study. The first measurement was made when the volunteers were in the supine position. The RIJV diameter and cross-sectional area were measured from the apex of the triangle formed by the clavicle and the two ends of the sternocleidomastoid muscle, which is used for the conventional approach. The second measurement was performed in a 20° Trendelenburg position. After the drainage of the veins using an Esbach bandage both arms were cuffed. The third measurement was made when tourniquets were inflated.MAIN OUTCOME MEASURE(S)Hemodynamic measurements and RIJV dimensions.RESULTSIn 65 volunteers the diameter and cross-sectional area of the RIJV were significantly widened in both Trendelenburg and tourniquet measurements compared with the supine position (P<.001 for both measures). Measurements using the upper extremity tourniquet were significantly larger than Trendelenburg measurements (P=.002 and <.001 for cross-sectional area and diameter, respectively).CONCLUSIONChannelling of the upper-extremity venous return to the jugular vein was significantly superior when compared with the Trendelenburg position and the supine position.LIMITATIONSNo catheterization and study limited to healthy volunteers.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of the Trendelenburg position versus upper-limb tourniquet on internal jugular vein diameter

Karaaslan

Gökay

Karakaya

et al. 2017

Annals of Saudi Medicine

View full text Add to dashboard Cite

show abstract

“…They found that in supine position the CSA of right IJV was larger than the left and also the increase in CSA after 10° Trendelenburg position was larger for right. 2 Increase in CSA is associated with a high success rate of catheterization and less complications. Different maneuvers such as Trendelenburg position, abdominal compression, valsalva, inspiratory hold, PEEP has been used in increase the diameter of the right IJV.…”

Section: Resultsmentioning

confidence: 99%

“…These have proved to increase the diameter of right IJV. [1][2][3][4] The cross sectional area has increased by 72.5% at 15 cm H 2 O PEEP when compared to 0 cm H 2 O PEEP in same patient. 4 Stenosis or thrombosis of right IJV, anatomical changes caused by head and neck surgeries and failure of right IJV catheterization will suggest the catheterization of left IJV be necessary.…”

Section: Introductionmentioning

confidence: 86%

“…Theoretically increasing the cross sectional area of the vein plummets the most common complication of IJV catheterization, that is, arterial puncture and increases the success rate. 2 For the purpose, Trendelenburg position, and positive end expiratory pressure (PEEP) are the most commonly used methods. These have proved to increase the diameter of right IJV.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of positive end expiratory pressure on left internal jugular vein size

Sharma

Shrestha

Moktan

et al. 2018

J. Kathmandu Med. Coll.

View full text Add to dashboard Cite

Background: Increasing the cross sectional area (CSA) of the left internal jugular vein facilitates cannulation and decreases complications. But, the literature is sparse regarding the methods to increase the cross sectional area of the left internal jugular vein.Objective: To assess the changes that occur in cross sectional area of left internal jugular vein after application of different levels of positive end expiratory pressure and compare the findings with right internal jugular vein.Methodology: Sixty-four patients were included. Antero posterior diameter, transverse diameter and cross sectional area of left and right internal jugular vein was measured using two-dimensional ultrasound before the induction of anesthesia and after intubation at positive end expiratory pressure of 0, 5, 10 and 15 cm H2O. Result: The increase in positive end expiratory pressure was associated with increase in cross sectional area, anteroposterior and transverse diameter of left internal jugular vein. At 10 cmH2 Opositive end expiratory pressure, left internal jugular vein cross sectional area increased significantly by 22.8% that is 1.34±0.53cm2(P value< 0.05). The right internal jugular vein is significantly larger than left at baseline and at all levels of studied positive end expiratory pressure. The percentage increase of cross sectional area for both internal jugular veins was similar.Conclusion: The left internal jugular vein cross sectional area increment has direct relationship with increment of positive end expiratory levels at studied points. However, above 10 cm H2O of positive end expiratory pressure, there was only non significant increase (P value > 0.05).

show abstract

“…Sometimes in our daily routine , we examine children who present with a mass in the neck named flebectasia, which is a widening of this vein. Although there are many studies related to jugular vein diameter in pediatric patients, there are very few studies related to the jugular vein diameter in adults 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Assesment of internal jugular vein diameters in Turkish adults

Erkan¹,

Tuhanioğlu²,

Arslan³

et al. 2018

Cumhuriyet Medical Journal

View full text Add to dashboard Cite

As the internal jugular vein (IJV) is a vessel used for cannulation in central venous approaches in medical applications, knowledge of the anatomic details is significant for clinicians knowing that vascular diameter varies according to age and gender is an extremely useful data. The aim of this study was to evaluate differences in the right and left side diameters of the internal jugular vein in normal adult Turkish population and to determine any relationship between these diameters and age, gender and maneuver. Method: The study included a total of 140 patients. The maximal transverse and anterior-posterior diameters of the internal jugular veins were measured on both sides, both with the patient at rest and during the Valsalva maneuver with USG. Results: No statistically significant difference was determined in respect of diameter values above and below 60 years of age(p<0.05). No statistically significant difference was determined between male and female genders in respect of all the diameter values (p<0.05) except LIJV in transverse diameter with valsalva .The right IJV diameter in both the transverse and anteroposterior sections were determined to be statistically significantly wider both at rest and during the Valsalva maneuver (p<0.05). Conclusions: According to the results of this study, the right-side IJV diameter was found to be statistically significantly greater than that of the left side in Turkish population. Valsalva effects, age and gender are non-effective on diameters. Distinguishing the diameters , surgical and interventional risks can be decreased.

show abstract

Effect of Trendelenburg position on right and left internal jugular vein cross-sectional area

Cited by 14 publications

References 29 publications

Comparison of the Trendelenburg position versus upper-limb tourniquet on internal jugular vein diameter

Comparison of the Trendelenburg position versus upper-limb tourniquet on internal jugular vein diameter

Impact of positive end expiratory pressure on left internal jugular vein size

Assesment of internal jugular vein diameters in Turkish adults

Contact Info

Product

Resources

About