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The trendelenburg position is usually applied to increase the cross-sectional area of the IJV. However, trendelenburg position requires a tilt table to place the head in the down position. Trendelenburg position could also increase intracranial pressure. Passive leg elevation redistributes more blood from the lower extremity into the central veins and is proved to increase the cross-sectional area of IJV in adults. However, the effect of leg elevation on the cross-sectional area of IJV in small infants and children has not been evaluated.
The investigators evaluated the effect of passive leg elevation on the cross-sectional area of IJV in subjects undergoing open heart surgery for congenital anomaly.
Internal jugular vein (IJV) cannulation is essential for open heart surgery of small infants and children for transfusion or inotropics infusion. The trendelenburg position is usually applied to increase the cross-sectional area of the IJV.
However, trendelenburg position requires a tilt table to place the head in the down position. Trendelenburg position could also increase intracranial pressure. Passive leg elevation redistributes more blood from the lower extremity into the central veins and is proved to increase the cross-sectional area of IJV in adults. However, the effect of leg elevation on the cross-sectional area of IJV in small infants and children has not been evaluated. Furthermore, the children undergoing open heart surgery due to cardiac anomaly have an altered hemodynamics and often congested right heart. Therefore, the response of passive leg elevation may be different from that of normal heart physiology. Therefore, we evaluated the effect of passive leg elevation on the cross-sectional area of IJV in subjects undergoing open heart surgery for congenital anomaly.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| patients undergoing open heart surgery | small infant or children patients undergoing open heart surgery |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| leg elevation | Other | bilateral passive leg elevation for 30 seconds |
|
| Measure | Description | Time Frame |
|---|---|---|
| Cross-sectional area of internal jugular vein | Cross-sectional area of internal jugular vein measured on the ultrasonographic image with planimetry method | one time measurement 10 min before jugular vein cannulation |
| Measure | Description | Time Frame |
|---|---|---|
| Transverse diameter of internal jugular vein | Transverse diameter of internal jugular vein measured on the ultrasonographic image | only one time measurements 10 min before internal jugular vein cannulation |
| horizontal diameter of internal jugular vein |
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Inclusion Criteria:
Exclusion Criteria:
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infants or children undergoing open heart surgery for congenital anomaly for study period
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| Name | Affiliation | Role |
|---|---|---|
| Chung Su Kim, M.D.,Ph.D. | Samsung Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Samsung Medical Center | Seoul | 135-710 | South Korea |
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| Trendelenburg position | Other | Trendelenburg position (15 degrees) for 30 seconds |
|
| Trendelenburg position + passive leg elevation | Other | Trendelenburg position + passive leg elevation |
|
| control group | Other | supine position without passive leg elevation or trendelenburg position |
|
horizontal diameter of internal jugular vein measured on the ultrasonographic image |
| only one time measurements 10 min before jugular vein cannulation |
| skin to internal jugular vein depth | skin to internal jugular vein depth measured on the ultrasonographic image | one time measurement 10 min before jugular vein cannulation |
| ID | Term |
|---|---|
| D018475 | Head-Down Tilt |
| D035061 | Control Groups |
| ID | Term |
|---|---|
| D011187 | Posture |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
| D015340 | Epidemiologic Research Design |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D012107 | Research Design |
| D008722 | Methods |
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