No Effect of Valsalva Maneuver or Trendelenburg Angle on Axillary Vein Size

Ford, Deanna R.; Witting, Michael D.; Vora, Milan V.; Sommerkamp, Sarah K.; Euerle, Brian D.

doi:10.1016/j.jemermed.2012.12.020

Cited by 8 publications

(9 citation statements)

References 8 publications

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“…The effectiveness of the Trendelenburg position is ques tionable with respect to the data confirming the low impact of the manoeuvre on the size of the crosssection of the vein [38].…”

Section: Practical Aspectsmentioning

confidence: 86%

Infraclavicular access to the axillary vein — new possibilities for the catheterization of the central veins in the intensive care unit

Gawda¹,

Czarnik²,

Łysenko

2016

Anaesthesiol Intensive Ther

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Central vein cannulation is one of the most commonly performed procedures in intensive care. Traditio nally, the jugular and subclavian vein are recommended as the first choice option. Nevertheless, these attempts are not always obtainable for critically ill patients. For this reason, the axillary vein seems to be a rational alternative approach. In this narrative review, we evaluate the usefulness of the infraclavicular access to the axillary vein. The existing evidence suggests that infraclavicular approach to the axillary vein is a reliable method of central vein catheterization, especially when performed with ultrasound guidance.

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“…The effectiveness of the Trendelenburg position is ques tionable with respect to the data confirming the low impact of the manoeuvre on the size of the crosssection of the vein [38].…”

Section: Practical Aspectsmentioning

confidence: 86%

Infraclavicular access to the axillary vein — new possibilities for the catheterization of the central veins in the intensive care unit

Gawda¹,

Czarnik²,

Łysenko

2016

Anaesthesiol Intensive Ther

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show abstract

“…All of the patients were positioned with their neck in extension and head rotated left at [20][21][22][23][24][25][26][27][28][29][30] . Patients were studied in State 0, table flat (no tilt), with the patients in the supine position, and State T, in which the operating table was tilted 15 to a TP.…”

Section: Methodsmentioning

confidence: 99%

“…These factors are well documented in chronic dialysis patients. 2,[23][24][25] Anemia, left ventricular hypertrophy, diastolic dysfunction and vascular dysfunction are all the characteristic manifestations in dialysis patients. An increasing number of older dialysis patients with diabetes mellitus and autonomic neuropathy caused by uremic poisoning of the baroreceptors [25][26][27] may stimulates morbidity of autonomic disorder in dialysis patients.…”

Section: 11mentioning

confidence: 99%

“…10 Therefore, excessive left rotation should be avoided to minimize the risk of unintentional CA puncture during right IJV cannulation. In the present study, each patient's head was positioned with the head rotated left at [20][21][22][23][24][25][26][27][28][29][30] . According to our review of the literature, the effects of TP on the overlap between the CA and the IJV have not yet been evaluated.…”

Section: 11mentioning

confidence: 99%

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Ultrasound validation of Trendelenburg positioning to increase internal jugular vein cross-sectional area in chronic dialysis patients

Nayman¹,

Önal

Apilioğulları

et al. 2015

Renal Failure

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“…Trendelenburg position which reduces collapsibility of the internal jugular vein is not helpful in axillary vein cannulation. 4 Arm abduction has been observed to reduce the collapsibility of infraclavicular axillary vein, 5 but the effect of arm abduction has not been systematically studied and quantified to suggest changes in clinical practice. Hence, we have designed this study to measure the respiratory variations of the infraclavicular axillary vein in two different arm positions (adduction and abduction) during spontaneous breathing.…”

Section: Introductionmentioning

confidence: 99%

Arm position and collapsibility of infraclavicular axillary vein during voluntary breathing: An ultrasound-guided observational study

et al. 2019

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Background: Arm abduction influences cross-sectional area of the infraclavicular axillary vein, yet the effect of arm abduction on collapsibility of the vein has not been quantified. Decrease in collapsibility of the axillary vein can enable successful cannulation and can decrease injury to underlying vital structures. Methods: The infraclavicular axillary vein was scanned in 70 patients close to the clavicle with a high-frequency linear transducer in arm adducted position (Point A), after arm abduction at the initial probe position (Point A′) and after tracing the vein medially close to clavicle (Point B). Maximum and minimum cross-sectional area and circumference during tidal breathing and collapsibility indices during tidal and deep breathing were measured at three probe positions. Results: The percentage change with respiration in cross-sectional area, circumference and the collapsibility indices computed from the above measurements were lesser in arm abducted position (p < 0.001). There was decrease in collapsibility index during tidal breathing from 25 at Point A to 7 at Point A′ and 3 at Point B. Collapsibility index reduced from 91 at Point A to 30 at Point A′ and 35 at Point B during deep breathing. Conclusion: We conclude that the collapsibility of the infraclavicular axillary vein could be reduced by arm abduction, and hence, abduction could be proposed as the ideal arm position for ultrasound-guided infraclavicular axillary vein cannulation.

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No Effect of Valsalva Maneuver or Trendelenburg Angle on Axillary Vein Size

Cited by 8 publications

References 8 publications

Infraclavicular access to the axillary vein — new possibilities for the catheterization of the central veins in the intensive care unit

Infraclavicular access to the axillary vein — new possibilities for the catheterization of the central veins in the intensive care unit

Ultrasound validation of Trendelenburg positioning to increase internal jugular vein cross-sectional area in chronic dialysis patients

Arm position and collapsibility of infraclavicular axillary vein during voluntary breathing: An ultrasound-guided observational study

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