Positive end-expiratory pressure to increase internal jugular vein size is poorly tolerated in obese anesthetized adults.

Abstract:

BACKGROUND:Central venous cannulation is technically challenging in obese patients. We hypothesized that positive end-expiratory pressure (PEEP) increases the size of the internal jugular vein (IJV) in obese adults. METHODS:The circumference and cross-sectional area of the IJV were measured in obese patients under general anesthesia at PEEP 0, 5, and 10 cm H2O. Results are reported as means ± SE. RESULTS:PEEP at 10 cm H2O was tolerated by 18 of 24 obese patients. Each 5 cm H2O of PEEP increased the cross-sectional area by 0.16 ± 0.02 cm (P < 0.0001) and the circumference by 0.23 ± 0.03 cm (P < 0.0001). CONCLUSIONS:PEEP modestly increases the size of the IJV in obese adults but was poorly tolerated because of hypotension.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Downey LA,Blaine KP,Sliwa J,Macario A,Brock-Utne J

doi

10.1213/ANE.0000000000000347

subject

Has Abstract

pub_date

2014-09-01 00:00:00

pages

619-21

issue

3

eissn

0003-2999

issn

1526-7598

pii

00000539-201409000-00018

journal_volume

119

pub_type

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