当前位置： SCI文献检索 > ANNALS OF SAUDI MEDICINE期刊下所有文献 > 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.

Abstract：

BACKGROUND:Central 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. OBJECTIVE:Compare the Trendelenburg position with upper-extremity venous return blockage using the tourniquet technique. DESIGN:Prospective clinical study. SETTING:University hospital. SUBJECTS AND METHODS:Healthy 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. RESULTS:In 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). CONCLUSION:Channelling of the upper-extremity venous return to the jugular vein was significantly superior when compared with the Trendelenburg position and the supine position. LIMITATIONS:No catheterization and study limited to healthy volunteers.

journal_name

Ann Saudi Med

journal_title

Annals of Saudi medicine

authors

Karaaslan P,Gokay BV,Karakaya MA,Darcin K,Karakaya AD,Ormeci T,Kose EA

doi

10.5144/0256-4947.2017.308

subject

Has Abstract

pub_date

2017-07-01 00:00:00

pages

308-312

issue

eissn

0256-4947

issn

0975-4466

journal_volume

pub_type

杂志文章

在线工具

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