Novel body positioning maximizes femoral venous size in adults: An ultrasonographic evaluation

Abstract

Introduction: Increased femoral vein size may lead to a higher first pass success rate during central venous cannulation. The aim of this study was to evaluate the effects of body position on femoral vein anatomy for cannulation. Methods: This prospective study examined the femoral vein of healthy volunteers by ultrasound scanner. The changes in cross-sectional area and diameter of the femoral vein were evaluated. Right-sided measurements were taken at four different leg positions: neutral, frog leg, backup , and back-up/frog leg position. Results: A total of 50 subjects were enrolled in the study. The mean femoral vein cross-sectional area were 0.57 ± 0.29 cm 2 , 0.90 ± 0.26 cm 2 , 1.05 ± 0.33 cm 2 , and 1.47 ± 0.34 cm 2 , and the mean femoral vein diameter were 0.75 ± 0.20 cm, 1.05 ± 0.28 cm, 1.25 ± 0.21 cm, and 1.46 ± 0.25 cm in order of neutral, backup , frog leg, and back-up/frog leg position (p < 0.001). Conclusion: Performing the right femoral vein catheterization in backup and frog leg position is associated with a greater cross-sectional area of the femoral vein.

Ultrasound-guided arterial catheterization

“…Arteriovenous fistula formation can occur after an inadvertent wall puncture between the femoral artery and femoral vein. In adults, external rotation and abduction of the leg (frog-leg position) [ 58 ] and a frog-leg position with a combination of back extension decreased the overlapping portion between the femoral artery and femoral vein [ 59 ]. In pediatric patients, leg abduction with a range between 48° and 58° and external hip rotation can minimize the overlap between the femoral artery and vein [ 60 ].…”