부산대학교 도서관

Objective: In the Trendelenburg position the patient is positioned in decubitus supinus with the feet raised in a plan above their head. It has been described to benefit blood return, hence increasing the size of the vein. This might aid in procedures such as central venous catheterization. However, this position is not comfortable for patients for long periods of time. The aim of this study was to determine an ergonomic angulation that increased the Right Internal Jugular Vein (RIJV) transverse area and diameter. Methods: An experimental study was carried out with healthy adults. They were randomly assigned to different positions at 15°, 10°, 5°, and 0° head down tilt, at a 5 minutes interval between each angulation. RIJV transverse diameter and area were measured at the level of the thyroid cartilage. A contralateral rotation of the head in 90°, 45° and 0° in relation to the central axis of the body was performed at each measured position. Results: A total of 54 participants were included. Age range was 22--32 years, with a BMI mean of 24.12. At Trendelenburg position with the different contralateral rotation of the head (90°, 45°, 0°) RIPJ area measurements were: 15º=1.50, 1.62, and 1.89 mm2, at 10º=1.33, 1.60, and 1.70 mm2; at 5º=1.46, 1.39, and 1.52 mm2, and at 0º=0.97, 1.11, and 1.39 mm2. Conclusion: Considering the low side effects of positioning patients in 5° with 45° head rotation, this was the best position for patients. Along with it, it had the best access area for RIJV. [ABSTRACT FROM AUTHOR]