ArticlePakistan journal of medical sciences
The effectiveness of trendelenburg positioning on the cross-sectional area of the right internal jugular vein in obese patients.
Article in Pakistan journal of medical sciences. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- Effect of 10 cm H₂O positive end-expiratory pressure on right internal jugular vein cross-sectional area in obese patients under general anesthesia: a prospective observational study.BMC anesthesiology · 2026Observational
- Ultrasound-guided supraclavicular internal jugular vein compression to increase internal jugular vein cross-sectional area in hospitalized patients: a prospective observational study in Japan.Acute and critical care · 2025Article
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- Article
- Breath-holding could improve visualization of the internal jugular veins by ultrasound guidance in obese patients with trauma.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Is the Trendelenburg position the only way to better visualize internal jugular veins?Acta medica Lituanic · 2018Article
- Neck Vessel Cross-Sectional Area Measured with MRI: Scan-Rescan Reproducibility for Longitudinal Evaluations.Journal of neuroimaging : official journal of the American Society of Neuroimaging · 2018Article
- Using Ultrasonography to Determine Optimal Head-down Tilt Position Angle in Patients before Catheterization of the Internal Jugular Vein.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2017Article
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTrendelenburg positioning is a common approach used during internal jugular vein (IJV) cannulation. No evidence indicates that Trendelenburg positioning significantly increases the cross-sectional area (CSA) of the IJV in obese patients. The primary aim of this study was to determine the effectiveness of Trendelenburg positioning on the CSA of the right internal jugular vein assessed with ultrasound measurement in obese patients.
methodsForty American Society of Anesthesiologists II patients with body mass index ≥30 kg/m(2) undergoing various elective surgeries under general endotracheal anesthesia were enrolled. Ultrasound images of the right IJV were obtained in a transverse orientation at the cricoid level. We measured the CSA of the right IJV two different conditions in a sealed envelope were applied in random order: State 0, table flat (no tilt), with the patients in the supine position, and State T, in which the operating table was tilted 20° to the Trendelenburg position.
resultsThe change in the CSA of the IJV from the supine to the Trendelenburg position (1.80 cm(2) vs 2.08cm(2)) was not significantly different. The CSA was paradoxically decreased in 10 of 36 patients when the position changed from State 0 to State T.
conclusionsTrendelenburg positioning does not significantly increase the mean CSA of the right IJV in obese patients. In fact, in some patients, this position decreases the CSA. The use of the Trendelenburg position for IJV cannulation in obese patients can no longer be supported.
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