Document Detail

Impact of Trendelenburg positioning on functional residual capacity and ventilation homogeneity in anaesthetised children.
MedLine Citation:
PMID:  17448055     Owner:  NLM     Status:  MEDLINE    
Trendelenburg positioning, a head-down tilt, is routinely used in anaesthesia when inserting a central venous catheter to increase the calibre of the jugular or subclavian veins and to prevent an air embolism. We investigated the impact of Trendelenburg positioning on functional residual capacity and ventilation homogeneity as well as the potential reversibility of these changes by repositioning and/or a recruitment manoeuvre in children with congenital heart disease. Functional residual capacity and ventilation homogeneity were assessed in 20 anaesthetised children between the ages of 3 months and 8 years who required central venous catheterisation before undergoing cardiac surgery. Functional residual capacity was measured (1) in the supine position, (2) in the Trendelenburg position, (3) after repositioning supine and (4) after a recruitment manoeuvre to total lung capacity which was performed by manually elevating the airway pressure to 40 cmH(2)O for ten consecutive breaths. Adopting the Trendelenburg position led to a significant decrease in functional residual capacity (median [range]- 12 (6-21)%) and increase in lung clearance index (12 (2-19)%). Baseline values were not reached after repositioning supine in any patient until after a standardised recruitment manoeuvre was performed.
A Regli; W Habre; S Saudan; C Mamie; T O Erb; B S von Ungern-Sternberg;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anaesthesia     Volume:  62     ISSN:  0003-2409     ISO Abbreviation:  Anaesthesia     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-23     Completed Date:  2007-06-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  England    
Other Details:
Languages:  eng     Pagination:  451-5     Citation Subset:  AIM; IM    
Department of Anaesthesia, Pharmacology and Intensive Care, University Hospitals of Geneva, Geneva, Switzerland.
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MeSH Terms
Anesthesia, General / methods*
Catheterization, Central Venous / methods
Child, Preschool
Functional Residual Capacity / physiology*
Head-Down Tilt / physiology*
Heart Defects, Congenital / surgery
Pulmonary Gas Exchange / physiology*
Supine Position / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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