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The effects of hip abduction with external rotation and reverse Trendelenburg position on the size of the femoral vein; ultrasonographic investigation.

Kim W, Chung RK, Lee GY, Han JI - Korean J Anesthesiol (2011)

Bottom Line: The F and FRT positions increased diameter, CSA and exposed width of the FV significantly compared with the N position.However, the F and FRT positions had no significant effect on exposed ratio of the FV compared with the N position.These positions may increase success rate and reduce complication rate and, therefore, can be useful for patients with difficult central venous access or at high-risk of catheter-related complication.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

ABSTRACT

Background: Femoral vein (FV) catheterization is required for critically ill patients, patients with difficult peripheral intravenous access, and patients undergoing major surgery. The purpose of this study was to evaluate the effects of hip abduction with external rotation (frog-leg position), and the frog-leg position during the reverse Trendelenburg position on diameter, cross-sectional area (CSA), exposed width and ratio of the FV using ultrasound investigation.

Methods: Ultrasonographic FV images of 50 adult subjects were obtained: 1) in the neutral position (N position); 2) in the frog-leg position (F position); 3) in the F position during the reverse Trendelenburg position (FRT position). Diameter, CSA, and exposed width of the FV were measured. Exposed ratio of the FV was calculated.

Results: The F and FRT positions increased diameter, CSA and exposed width of the FV significantly compared with the N position. However, the F and FRT positions had no significant effect on exposed ratio of the FV compared with the N position. The FRT position was more effective than the F position in increasing FV size.

Conclusions: The F and FRT positions can be used to increase FV size during catheterization. These positions may increase success rate and reduce complication rate and, therefore, can be useful for patients with difficult central venous access or at high-risk of catheter-related complication.

No MeSH data available.


Related in: MedlinePlus

Ultrasonographic images of the femoral vein in a subject in the neutral (A), frog-leg (B), and frog-leg position during the reverse Trendelenburg position (C). Diameter, cross-sectional area, and exposed width of the femoral vein increased significantly in the frog-leg position and the reverse Trendelenburg position with the frog-leg position. FV: femoral vein, FA: femoral artery.
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Figure 2: Ultrasonographic images of the femoral vein in a subject in the neutral (A), frog-leg (B), and frog-leg position during the reverse Trendelenburg position (C). Diameter, cross-sectional area, and exposed width of the femoral vein increased significantly in the frog-leg position and the reverse Trendelenburg position with the frog-leg position. FV: femoral vein, FA: femoral artery.

Mentions: The F and FRT positions significantly increased FV diameter, CSA, and exposed width (17.3% and 32.7%, P < 0.001; 31.3% and 77.2%, P < 0.001; 23.7% and 38.0%, P < 0.001; respectively) (Fig. 2, Table 2) compared with the N position. However, exposed ratio of the FV was not significantly increased (P = 0.061) (Table 2).


The effects of hip abduction with external rotation and reverse Trendelenburg position on the size of the femoral vein; ultrasonographic investigation.

Kim W, Chung RK, Lee GY, Han JI - Korean J Anesthesiol (2011)

Ultrasonographic images of the femoral vein in a subject in the neutral (A), frog-leg (B), and frog-leg position during the reverse Trendelenburg position (C). Diameter, cross-sectional area, and exposed width of the femoral vein increased significantly in the frog-leg position and the reverse Trendelenburg position with the frog-leg position. FV: femoral vein, FA: femoral artery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3198180&req=5

Figure 2: Ultrasonographic images of the femoral vein in a subject in the neutral (A), frog-leg (B), and frog-leg position during the reverse Trendelenburg position (C). Diameter, cross-sectional area, and exposed width of the femoral vein increased significantly in the frog-leg position and the reverse Trendelenburg position with the frog-leg position. FV: femoral vein, FA: femoral artery.
Mentions: The F and FRT positions significantly increased FV diameter, CSA, and exposed width (17.3% and 32.7%, P < 0.001; 31.3% and 77.2%, P < 0.001; 23.7% and 38.0%, P < 0.001; respectively) (Fig. 2, Table 2) compared with the N position. However, exposed ratio of the FV was not significantly increased (P = 0.061) (Table 2).

Bottom Line: The F and FRT positions increased diameter, CSA and exposed width of the FV significantly compared with the N position.However, the F and FRT positions had no significant effect on exposed ratio of the FV compared with the N position.These positions may increase success rate and reduce complication rate and, therefore, can be useful for patients with difficult central venous access or at high-risk of catheter-related complication.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

ABSTRACT

Background: Femoral vein (FV) catheterization is required for critically ill patients, patients with difficult peripheral intravenous access, and patients undergoing major surgery. The purpose of this study was to evaluate the effects of hip abduction with external rotation (frog-leg position), and the frog-leg position during the reverse Trendelenburg position on diameter, cross-sectional area (CSA), exposed width and ratio of the FV using ultrasound investigation.

Methods: Ultrasonographic FV images of 50 adult subjects were obtained: 1) in the neutral position (N position); 2) in the frog-leg position (F position); 3) in the F position during the reverse Trendelenburg position (FRT position). Diameter, CSA, and exposed width of the FV were measured. Exposed ratio of the FV was calculated.

Results: The F and FRT positions increased diameter, CSA and exposed width of the FV significantly compared with the N position. However, the F and FRT positions had no significant effect on exposed ratio of the FV compared with the N position. The FRT position was more effective than the F position in increasing FV size.

Conclusions: The F and FRT positions can be used to increase FV size during catheterization. These positions may increase success rate and reduce complication rate and, therefore, can be useful for patients with difficult central venous access or at high-risk of catheter-related complication.

No MeSH data available.


Related in: MedlinePlus