The Optimal Angle of Head Rotation for Internal Jugular Cannulation as Determined by Ultrasound Evaluation.
J Cardiothorac Vasc Anesth
; 29(5): 1257-60, 2015 Oct.
Article
em En
| MEDLINE
| ID: mdl-25998069
ABSTRACT
OBJECTIVES:
The aim of this study was to determine the degree of head rotation that creates the maximal anatomic separation between the right internal jugular vein and the carotid artery.DESIGN:
Single-center prospective, observational cohort study.SETTING:
University medical center.PARTICIPANTS:
Fifty patients aged>21 years and undergoing cardiac surgery.INTERVENTIONS:
An ultrasound machine equipped with a digital caliper was used to determine the relational anatomy of the internal jugular vein and the carotid artery, with patients in the Trendelenburg position at head angles of -15°, 0°,+15°,+30°,+45°,+60°,+75°, and+90°. MEASUREMENTS AND MAINRESULTS:
When examining the percentage of the internal jugular vein vertical diameter that is not overlapped by the carotid artery (vertically unencumbered), there was a difference between the head angle groups (p<0.01). Unencumbered vertical distance was different between+75° versus 0°, and+75° versus+15°. At+75°, 60.3%±5.3% of the internal jugular vein was unencumbered vertically, whereas at 0°, it was 37.2%±3.9%, and at+15° it was 40.3%±3.8%. Only 72% of the patients were able to position their head at+75°, and 54% of the subjects were able to position their head at+90°.CONCLUSION:
The authors found the internal jugular vein becomes more vertically separated from the carotid artery at more extreme angles of contralateral head rotation.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Cateterismo Venoso Central
/
Posicionamento do Paciente
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Lesões do Sistema Vascular
/
Veias Jugulares
Tipo de estudo:
Diagnostic_studies
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Observational_studies
/
Prognostic_studies
Limite:
Aged
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article