Comparison of the effect of different degrees of passive leg raising on the internal jugular vein cross-sectional area in patients before thoracic surgery
Abstract Background This study investigated the effect of different degrees of passive leg raising (PLR) on the internal jugular vein (IJV) cross-sectional area (CSA) and on the success rate of IJV cannulation in patients waiting for thoracic surgery, to analyze whether body mass index (BMI), gender...
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| Language: | English |
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BMC
2019-05-01
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| Series: | BMC Anesthesiology |
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| Online Access: | http://link.springer.com/article/10.1186/s12871-019-0751-5 |
| _version_ | 1818060063062884352 |
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| author | Shouyu Xie Qimeng Yu Tingting Li Meiying Xu Jingxiang Wu Yanting Li |
| author_facet | Shouyu Xie Qimeng Yu Tingting Li Meiying Xu Jingxiang Wu Yanting Li |
| author_sort | Shouyu Xie |
| collection | DOAJ |
| description | Abstract Background This study investigated the effect of different degrees of passive leg raising (PLR) on the internal jugular vein (IJV) cross-sectional area (CSA) and on the success rate of IJV cannulation in patients waiting for thoracic surgery, to analyze whether body mass index (BMI), gender, age, fasting time and preoperative rehydration have any impact on changes in the IJV CSA. Methods Eighty-two patients scheduled for selective thoracic surgery were enrolled in this study. Patients were randomly assigned based on a computer-generated randomization sequence into 3 groups: 0, 30, and 50 degrees (n = 32, 25, and 25 patients, respectively). The right IJV CSA in the sequence of 0-degree (supine position), 30-degree and 50-degree PLR positions was recorded in all patients using an ultrasound probe. The relationship of BMI, gender, age, fasting time and preoperative rehydration to the IJV CSA was analyzed. Then, each patient was returned to a supine position. After waiting for at least 5 min, patients were placed in a PLR position at 0, 30, or 50 degrees, and then IJV cannulation was performed without ultrasound guidance. The success rate of IJV catheterization at different PLR angles was compared. Results The average CSA of the right IJV in the supine position, 30-degree PLR position and 50-degree PLR position was 1.39 ± 0.63 cm2, 1.65 ± 0.73 cm2, and 1.68 ± 0.71 cm2, respectively. These results showed gradual increases in the IJV CSA of 18.5% (30-degree PLR) and 20.2% (50-degree PLR) when compared to that in the supine position (P = 0.045 and 0.025, respectively). However, only fasting time had a significant impact on the increase in the right IJV CSA at different PLR angles (P = 0.026). Other factors, such as BMI, gender, age and preoperative rehydration, had no significant effects. The success rates of IJV catheterization at angles of 0, 30 and 50 degrees were 84.3, 88 and 92%, respectively; however, there were no significant differences among the three groups (P = 0.674). Conclusions PLR increases the CSA of the right IJV, especially for patients with long fasting times before thoracic surgery. The effect of the 30-degree PLR position is similar to that of the 50-degree PLR position. However, the success rate of right IJV catheterization was not enhanced in this study using landmark-guided puncture, even though the CSA of the right IJV was increased. Trial registration Clinical trial registration number: ChiCTR1800015051. Date of registration: March 2018. |
| first_indexed | 2024-12-10T13:26:27Z |
| format | Article |
| id | doaj.art-17ba5e07dca94e2cb1c7405046b3178c |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-10T13:26:27Z |
| publishDate | 2019-05-01 |
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| series | BMC Anesthesiology |
| spelling | doaj.art-17ba5e07dca94e2cb1c7405046b3178c2022-12-22T01:47:08ZengBMCBMC Anesthesiology1471-22532019-05-011911910.1186/s12871-019-0751-5Comparison of the effect of different degrees of passive leg raising on the internal jugular vein cross-sectional area in patients before thoracic surgeryShouyu Xie0Qimeng Yu1Tingting Li2Meiying Xu3Jingxiang Wu4Yanting Li5Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong UniversityDepartment of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong UniversityDepartment of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong UniversityDepartment of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong UniversityDepartment of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong UniversityDepartment of Industrial Engineering and Management, School of Mechanical Engineering, Shanghai Jiao Tong UniversityAbstract Background This study investigated the effect of different degrees of passive leg raising (PLR) on the internal jugular vein (IJV) cross-sectional area (CSA) and on the success rate of IJV cannulation in patients waiting for thoracic surgery, to analyze whether body mass index (BMI), gender, age, fasting time and preoperative rehydration have any impact on changes in the IJV CSA. Methods Eighty-two patients scheduled for selective thoracic surgery were enrolled in this study. Patients were randomly assigned based on a computer-generated randomization sequence into 3 groups: 0, 30, and 50 degrees (n = 32, 25, and 25 patients, respectively). The right IJV CSA in the sequence of 0-degree (supine position), 30-degree and 50-degree PLR positions was recorded in all patients using an ultrasound probe. The relationship of BMI, gender, age, fasting time and preoperative rehydration to the IJV CSA was analyzed. Then, each patient was returned to a supine position. After waiting for at least 5 min, patients were placed in a PLR position at 0, 30, or 50 degrees, and then IJV cannulation was performed without ultrasound guidance. The success rate of IJV catheterization at different PLR angles was compared. Results The average CSA of the right IJV in the supine position, 30-degree PLR position and 50-degree PLR position was 1.39 ± 0.63 cm2, 1.65 ± 0.73 cm2, and 1.68 ± 0.71 cm2, respectively. These results showed gradual increases in the IJV CSA of 18.5% (30-degree PLR) and 20.2% (50-degree PLR) when compared to that in the supine position (P = 0.045 and 0.025, respectively). However, only fasting time had a significant impact on the increase in the right IJV CSA at different PLR angles (P = 0.026). Other factors, such as BMI, gender, age and preoperative rehydration, had no significant effects. The success rates of IJV catheterization at angles of 0, 30 and 50 degrees were 84.3, 88 and 92%, respectively; however, there were no significant differences among the three groups (P = 0.674). Conclusions PLR increases the CSA of the right IJV, especially for patients with long fasting times before thoracic surgery. The effect of the 30-degree PLR position is similar to that of the 50-degree PLR position. However, the success rate of right IJV catheterization was not enhanced in this study using landmark-guided puncture, even though the CSA of the right IJV was increased. Trial registration Clinical trial registration number: ChiCTR1800015051. Date of registration: March 2018.http://link.springer.com/article/10.1186/s12871-019-0751-5Thoracic surgeryInternal jugular veinCross-sectional areaPassive leg raising position |
| spellingShingle | Shouyu Xie Qimeng Yu Tingting Li Meiying Xu Jingxiang Wu Yanting Li Comparison of the effect of different degrees of passive leg raising on the internal jugular vein cross-sectional area in patients before thoracic surgery BMC Anesthesiology Thoracic surgery Internal jugular vein Cross-sectional area Passive leg raising position |
| title | Comparison of the effect of different degrees of passive leg raising on the internal jugular vein cross-sectional area in patients before thoracic surgery |
| title_full | Comparison of the effect of different degrees of passive leg raising on the internal jugular vein cross-sectional area in patients before thoracic surgery |
| title_fullStr | Comparison of the effect of different degrees of passive leg raising on the internal jugular vein cross-sectional area in patients before thoracic surgery |
| title_full_unstemmed | Comparison of the effect of different degrees of passive leg raising on the internal jugular vein cross-sectional area in patients before thoracic surgery |
| title_short | Comparison of the effect of different degrees of passive leg raising on the internal jugular vein cross-sectional area in patients before thoracic surgery |
| title_sort | comparison of the effect of different degrees of passive leg raising on the internal jugular vein cross sectional area in patients before thoracic surgery |
| topic | Thoracic surgery Internal jugular vein Cross-sectional area Passive leg raising position |
| url | http://link.springer.com/article/10.1186/s12871-019-0751-5 |
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