Positive end-expiratory pressure to increase internal jugular vein size is poorly tolerated in obese anesthetized adults.
prospective_cohort · Level II
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- Record sourced from PubMed, PMID 25137000.
- Also identified by DOI 10.1213/ANE.0000000000000347.
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Abstract
Central venous cannulation is technically challenging in obese patients. We hypothesized that positive end-expiratory pressure (PEEP) increases the size of the internal jugular vein (IJV) in obese adults. The circumference and cross-sectional area of the IJV were measured in obese patients under general anesthesia at PEEP 0, 5, and 10 cm H2O. Results are reported as means ± SE. PEEP at 10 cm H2O was tolerated by 18 of 24 obese patients. Each 5 cm H2O of PEEP increased the cross-sectional area by 0.16 ± 0.02 cm (P < 0.0001) and the circumference by 0.23 ± 0.03 cm (P < 0.0001). PEEP modestly increases the size of the IJV in obese adults but was poorly tolerated because of hypotension.
Medical subject headings
- Anesthesia
- Jugular Veins
- Obesity
- Positive-Pressure Respiration