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Relationship between positive end‐expiratory pressure and internal jugular vein cross‐sectional area
Author(s) -
LEE S. C.,
HAN S. S.,
SHIN S. Y.,
LIM Y. J.,
KIM J. T.,
KIM Y. H.
Publication year - 2012
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2011.02638.x
Subject(s) - medicine , positive end expiratory pressure , supine position , cricoid cartilage , internal jugular vein , anesthesia , american society of anesthesiologists , larynx , surgery , mechanical ventilation
Background Application of positive end‐expiratory pressure ( PEEP ) has been used to increase the cross‐sectional area ( CSA ) of the right internal jugular vein ( IJV ) in order to facilitate catheterisation. We aimed to determine the PEEP level at which the maximum increase of CSA occurred. Methods We enrolled 60 A merican S ociety of A nesthesiologists physical status I and II patients undergoing general endotracheal anaesthesia. The CSA was measured in the supine position with no PEEP (control condition, P 0) and after applying five different PEEPs in random order: 3 ( P 3), 6 ( P 6), 9 ( P 9), 12 ( P 12), and 15 ( P 15) cm H 2 O . Ultrasound was used to measure and record the CSA of the right IJV at the level of the cricoid cartilage. Results All PEEP levels increased the CSA of the right IJV relative to the control (all P < 0.05). On average, P 3, P 6, P 9, P 12, and P 15 increased the CSA by 21.5, 37.4, 51.9, 66.5, and 72.4%, respectively. There was no significant increase in CSA above a PEEP of 12 cm H 2 O . Conclusion The application of PEEP effectively increases the CSA of the right IJV . The PEEP giving the largest CSA is 12 cm H 2 O .