Ultrasound validation of maneuvers to increase internal jugular vein cross-sectional area and decrease compressibility

The Effects of Trendelenburg Position, Positive Intrathoracic Pressure and Head Rotation on Cross-sectional Area of Internal Jugular Vein

“…Yine bu çalışmada kombine ya da tek başına kullanıldığında kesit alanı % 50'den daha fazla artıran tek manevranın valsalva olduğu gösterilmiştir. Ayrıca bu çalışmada ven girişinin İJV'de neden olduğu kollapsı en etkili önleyen manevranın valsalva olduğu belirtilmiştir [15] .…”

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

“…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. A goniometer was used to measure the tilt angle of the table from the horizontal plane.…”

“…This shifting leads to an increase of venous return to the heart and hence, an increase in the CSA of the IJV, left ventricular end-diastolic volume and cardiac output. 2,9,15 One meta-analysis concluded that cardiac output increased by 9% at 1 min of TP. This effect persisted after the first minute by 4% and returned to baseline 10 min after equilibrium by autoregulation.…”

“…This effect persisted after the first minute by 4% and returned to baseline 10 min after equilibrium by autoregulation. 15 Furthermore, TP has potentially deleterious effects, especially in critically ill patients. 9 Increased work of breathing, decreased lung compliance, cardiac ischemia, raised intracerebral and intraocular pressures, decreased cerebral perfusion pressure, cardiac dysrhythmias, hypoxemia, and subjective distress and discomfort have all been reported.…”

“…9 Increased work of breathing, decreased lung compliance, cardiac ischemia, raised intracerebral and intraocular pressures, decreased cerebral perfusion pressure, cardiac dysrhythmias, hypoxemia, and subjective distress and discomfort have all been reported. 9,[15][16][17] Most studies which evaluate the effects of the TP on the CSA of the IJV have been performed on healthy subjects, surgical patients or intensive care patients. 9,[18][19][20][21][22] The effect of the TP on the CSA of the IJV in dialysis patients is largely unknown.…”