Trendelenburg position for internal jugular vein catheterization: A systematic review and meta-analysis

2021 ◽  
pp. 112972982110313
Author(s):  
Mariana Garcia-Leal ◽  
Santos Guzman-Lopez ◽  
Adrian Manuel Verdines-Perez ◽  
Humberto de Leon-Gutierrez ◽  
Bernardo Alfonso Fernandez-Rodarte ◽  
...  

To determine the effect of Trendelenburg position on the diameter or cross-section area of the internal jugular vein (IJV) a systematic review and metanalysis was performed. Studies that evaluated the cross-sectional area (CSA) and anteroposterior (AP) diameter of the right internal jugular vein (RIJV) with ultrasonography in supine and any degree of head-down tilt (Trendelenburg position) were analyzed. A total of 22 articles (613 study subjects) were included. A >5° Trendelenburg position statistically increases RIJV CSA and AP diameter. Further inclination from 10° does not statistically benefit IJV size. This position should be recommended for CVC placement, when patient conditions allow it, and US-guided cannulation is not available.

2021 ◽  
Vol 233 (5) ◽  
pp. e246
Author(s):  
Alejandro Quiroga-Garza ◽  
Mariana Garcia-Leal ◽  
Adrian M. Verdines-Perez ◽  
Humberto de Leon-Gutierrez ◽  
Bernardo Alfonso Fernandez-Rodarte ◽  
...  

2021 ◽  
Vol 35 (S1) ◽  
Author(s):  
Alejandro Quiroga‐Garza ◽  
Bernardo Fernandez‐Rodarte ◽  
Neri Alvarez‐Villalobos ◽  
Adrian Verdines‐Perez ◽  
Mariana Garcia‐Leal ◽  
...  

2019 ◽  
Vol 20 (6) ◽  
pp. 672-676
Author(s):  
Mehmet S Uluer ◽  
Mehmet Sargin ◽  
Betül Başaran

Background: Central venous cannulation is an invasive procedure commonly used by many physicians. The aim of this study was to evaluate the effects of the right lateral tilt position on the cross-sectional area and size of the right internal jugular vein, and the relationship between the right internal jugular vein and the carotid artery. Method: Forty healthy volunteers aged over 18 years were included in this prospective, observational study. The right internal jugular vein cross-sectional area and the anatomic relationship with the carotid artery were assessed using ultrasound imaging. This measurement was repeated for four positions (baseline position, 10° right tilt position, 10° Trendelenburg position, and 10° right tilt + 10° Trendelenburg position). The head was rotated 30° to the contralateral side in all patients. Results: The mean (standard deviation) right internal jugular vein cross-sectional area, transverse diameter, and anteroposterior diameter were significantly increased with the Trendelenburg position and 10° right tilt + 10° Trendelenburg position (p < 0.05). There were no significant differences in right internal jugular vein cross-sectional area, transverse diameter, and anteroposterior diameter between the baseline position and 10° right tilt position (p > 0.05). Conclusion: We found that the right lateral tilt position had no effect on the internal jugular vein cross-sectional area and that the Trendelenburg position was still the most valid position for safely increasing the right internal jugular vein cross-sectional area.


2021 ◽  
Vol 92 (3) ◽  
pp. 207-211
Author(s):  
Jason David ◽  
Richard A. Scheuring ◽  
Andrew Morgan ◽  
Cara Olsen ◽  
Ashot Sargsyan ◽  
...  

BACKGROUND: To date, we lack U.S. data on the effects of the long-used Russian tilt-table training protocol known as the Russian pre-launch tilt-table training protocol on internal jugular vein cross sectional area (IJV-CSA) in microgravity.CASE REPORT: A case study of a single healthy male astronaut volunteer was used for this study. The right IJV-CSA was measured using real time ultrasound at set times throughout the Russian pre-launch tilt-table training protocol, a method of physiological preparation for microgravity using tilt-table training. In microgravity, the subjects right IJV-CSA was measured again for comparison. The mean difference from in-flight right IJV-CSA for pre-tilt (0) was 0.438 cm2, for 15 was 0.887 cm2, for 30 was 0.864 cm2, for 50 was 1.15 cm2, and for post-tilt (0) the difference was 0.305 cm2.DISCUSSION: The cross-sectional areas of the subjects right IJV-CSA were significantly different between in-flight values and several angles of the Russian tilt-table protocol, except for the 0 measurement. In summary, this case-study represents the first time IJV-CSA has been compared between various angles of a tilt-table training protocol and microgravity in the same astronaut subject. The findings support prior cohort studies studying the same principles. Further investigation is merited; both to better describe the relationship between the cardiovascular effects of tilt-table simulations of microgravity and their correlating in-flight values, and to evaluate and study the Russian tilt-table protocol effects on cardiovascular physiology from a training and preparation perspective.David J, Scheuring RA, Morgan A, Olsen C, Sargsyan A, Grishin A. Comparison of internal jugular vein cross-section area during a Russian tilt-table protocol and microgravity. Aerosp Med Hum Perform. 2021; 92(3):207211.


2005 ◽  
Vol 33 (1) ◽  
pp. 82-86 ◽  
Author(s):  
W. Schummer ◽  
C. Schummer ◽  
R. Frober ◽  
J. Fuchs ◽  
M. Simon ◽  
...  

This prospective clinical investigation assessed the effect of placement of a Univent® tube on the anatomy of the internal jugular veins and the success of cannulation of the left internal jugular vein. After obtaining informed consent, 48 adult patients were enrolled. Of these, 42 patients were eligible and were divided into two groups: Univent® tube (group U, n=21) and wire enforced endotracheal tube (group C, n=21). The Univent® tube group were having a left thoracotomy. Using horizontal ultrasound scans just above the thyroid gland, the internal jugular vein was visualized and measured before and after Univent® placement. The number of needle passes necessary to cannulate the left internal jugular vein in the two groups was also compared. Univent® tubes were associated with lateral displacement of the right carotid artery and internal jugular vein on the convex side of the Univent® tube, with compression of the right internal jugular vein by the artery, resulting in a kidney-shaped cross-section of the vein. On the left (concave side of the tube), the neck was indented, the sheath of the left carotid artery was displaced medially, and the left internal jugular vein distorted to an ellipse. There was a significant increase in the lateral diameter and a decrease in the cross-sectional area of the left internal jugular vein (t-test, P<0.05). The first attempt at cannulation of the left internal jugular vein failed significantly more often in the Univent® group (13/21 vs 5/21 in group C, Chi-square 6.22, P=0.025). Cannulation of the internal jugular vein before placement of the Univent® tube, or placement with ultrasound guidance is suggested.


2018 ◽  
Vol 47 (1-3) ◽  
pp. 58-61
Author(s):  
Pan Xie ◽  
Kanfu Peng ◽  
Keqin Zhang ◽  
Hongwen Zhao ◽  
Yuxiu Sheng ◽  
...  

In most situations, central catheters are implanted in the right jugular vein as initial access for hemodialysis. However, after repeated punctures, the proximal vessels become stenosed and thrombosed and misplacement is likely to occur. Correct catheter position in the vein can be easily ascertained with X-ray or cross-sectional CT imaging. In this report, we describe the case of a 77-year-old patient on chronic hemodialysis via catheter due to arteriovenous fistula dysfunction. We placed a cuffed-tunneled hemodialysis catheter in the left internal jugular vein. Malpositioning of the catheter led to perforation of the great veins and migration of the catheter tip into the chest. It is important to be aware of the risk of potential incorrect positioning of dialysis catheters. Due to the stenosis and fragility of the vessel wall, perforation may occur. In cases of doubt, correct placement of large-bore catheters via the internal jugular vein should be verified by means of appropriate imaging before hemodialysis is performed.


2013 ◽  
Vol 10 (2) ◽  
pp. 45-49 ◽  
Author(s):  
SM Akram Hossain ◽  
SM Moshadeq Hossain ◽  
Fakhrul Amin Mohammad Hasanul Banna

Context: The jugular foramen is one of the most fascinating foramen present at the base of the skull attracting the imagination of many Anatomists worldwide as many important structures pass through it, and amongst them the intriguing structure is the internal jugular vein. The shape and size of the jugular foramen is related to the size of the internal jugular vein and the presence or absence of a prominent superior bulb. As most of the textbooks of Anatomy describe that the right jugular foramen is usually larger than the left jugular foramen. Henceforth the present study was undertaken in 55 skulls from the dept. of Anatomy. Measurements were taken with the help of sliding vernier caliper. Study type: Cross-sectional descriptive type. Place and period of study: Department of Anatomy, Rajshahi Medical College, Rajshahi and Pabna Medical College, Pabna from April 2010 to June 2011. Materials and Methods: Total fifty five (55) human adult skulls were collected from the Anatomy department of Rajshahi Medical College, Rajshahi and Pabna Medical College, Pabna at different times of the study period. The study was conducted to observe variations in the structure of the jugular foramen of the human’s skull. Result: Out of 55 skulls (110 foramina) studied, the presence of dome indicating the presence of jugular bulb was found bilaterally in 100% of cases. 58.18% of cases showed that the size of right foramina were larger than the left foramina whereas 20% of cases showed that right foramina were equal to the left and in 21.82% of cases the left foramina were larger than the right side foramina. An important observation in the present study was the presence of either complete or partial septation in the jugular foramen. Conclusion: The findings of the study reveals that there are some differences among some parameters. The variations are might be due to the geographical variations of the skeletons. It needs further study with larger sample size from different geographical areas of Bangladesh. DOI: http://dx.doi.org/10.3329/bja.v10i2.17281 Bangladesh Journal of Anatomy, July 2012, Vol. 10 No. 2 pp 45-49


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