Effect of head and shoulder positioning on the cross-sectional area of the subclavian vein in obese subjects
Head and shoulder positioning may affect cross-sectional area (CSA) and location of the subclavian vein (SCV). We investigated the CSA of the SCV and the depth of the SCV, depending on the head and shoulder positions. In 24 healthy obese volunteers, the short axis ultrasound images of the SCV and ad...
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| Veröffentlicht in: | The American journal of emergency medicine 2021-12, Vol.50, p.561-565 |
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| creator | Kim, Hyerim Chang, Jee-Eun Won, Dongwook Lee, Jung-Man Kim, Tae Kyong Min, Seong-Won Kim, Chanho Hwang, Jin-Young |
| description | Head and shoulder positioning may affect cross-sectional area (CSA) and location of the subclavian vein (SCV). We investigated the CSA of the SCV and the depth of the SCV, depending on the head and shoulder positions.
In 24 healthy obese volunteers, the short axis ultrasound images of the SCV and adjacent structures were obtained in three different head positions (neutral, 30° turned to the contralateral side, and 30° turned to the ipsilateral side) and two different shoulder positions (neutral and lowered). Images of the right and left SCVs were obtained in the supine and Trendelenburg positions. Subsequently, the CSA and depth of the SCV were measured.
Significant differences were found in the CSA of the SCV in different head positions (30° turned to contralateral side vs. neutral: −0.06 cm2, 95% confidence interval [CI], −0.10 to −0.02; Pcorrected = 0.002, 30° turned to contralateral side vs. 30° turned to ipsilateral side: −0.16 cm2, 95% CI, −0.22 to −0.11; Pcorrected |
| doi_str_mv | 10.1016/j.ajem.2021.08.013 |
| format | Article |
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In 24 healthy obese volunteers, the short axis ultrasound images of the SCV and adjacent structures were obtained in three different head positions (neutral, 30° turned to the contralateral side, and 30° turned to the ipsilateral side) and two different shoulder positions (neutral and lowered). Images of the right and left SCVs were obtained in the supine and Trendelenburg positions. Subsequently, the CSA and depth of the SCV were measured.
Significant differences were found in the CSA of the SCV in different head positions (30° turned to contralateral side vs. neutral: −0.06 cm2, 95% confidence interval [CI], −0.10 to −0.02; Pcorrected = 0.002, 30° turned to contralateral side vs. 30° turned to ipsilateral side: −0.16 cm2, 95% CI, −0.22 to −0.11; Pcorrected < 0.001, Neutral vs. 30° turned to ipsilateral side: −0.10 cm2, 95% CI, −0.14 to −0.07; Pcorrected < 0.001). The CSA of the SCV was significantly different, depending on shoulder positions (neutral vs. lowered: 0.44 cm2, 95% CI, 0.33 to 0.54; Pcorrected < 0.001), and body position (supine vs. Trendelenburg: −0.15 cm2, 95% CI, −0.19 to −0.12; Pcorrected < 0.001). However, the depth of the SCV did not differ with respect to head, shoulder, and body positions.
Ipsilateral 30° head rotation, neutral shoulder position, and Trendelenburg position significantly enhanced the CSA of the SCV in obese participants.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2021.08.013</identifier><identifier>PMID: 34555660</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Body Mass Index ; Catheterization, Central Venous ; Catheters ; Cross-sectional area ; Emergency medical care ; Female ; Head ; Head-Down Tilt ; Humans ; Intubation ; Male ; Middle Aged ; Obese ; Obesity ; Obesity - diagnostic imaging ; Patient Positioning ; Patients ; Pneumothorax ; Shoulder ; Skin ; Subclavian vein ; Subclavian Vein - diagnostic imaging ; Supine Position ; Ultrasonic imaging ; Ultrasonography ; Ultrasound ; Variance analysis ; Veins & arteries</subject><ispartof>The American journal of emergency medicine, 2021-12, Vol.50, p.561-565</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><rights>2021. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c335t-835cc9bf134c50682cc3250ce230b811b894ff734d9befa7721302875e1729113</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2604821963?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994,64384,64386,64388,72240</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34555660$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Hyerim</creatorcontrib><creatorcontrib>Chang, Jee-Eun</creatorcontrib><creatorcontrib>Won, Dongwook</creatorcontrib><creatorcontrib>Lee, Jung-Man</creatorcontrib><creatorcontrib>Kim, Tae Kyong</creatorcontrib><creatorcontrib>Min, Seong-Won</creatorcontrib><creatorcontrib>Kim, Chanho</creatorcontrib><creatorcontrib>Hwang, Jin-Young</creatorcontrib><title>Effect of head and shoulder positioning on the cross-sectional area of the subclavian vein in obese subjects</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>Head and shoulder positioning may affect cross-sectional area (CSA) and location of the subclavian vein (SCV). We investigated the CSA of the SCV and the depth of the SCV, depending on the head and shoulder positions.
In 24 healthy obese volunteers, the short axis ultrasound images of the SCV and adjacent structures were obtained in three different head positions (neutral, 30° turned to the contralateral side, and 30° turned to the ipsilateral side) and two different shoulder positions (neutral and lowered). Images of the right and left SCVs were obtained in the supine and Trendelenburg positions. Subsequently, the CSA and depth of the SCV were measured.
Significant differences were found in the CSA of the SCV in different head positions (30° turned to contralateral side vs. neutral: −0.06 cm2, 95% confidence interval [CI], −0.10 to −0.02; Pcorrected = 0.002, 30° turned to contralateral side vs. 30° turned to ipsilateral side: −0.16 cm2, 95% CI, −0.22 to −0.11; Pcorrected < 0.001, Neutral vs. 30° turned to ipsilateral side: −0.10 cm2, 95% CI, −0.14 to −0.07; Pcorrected < 0.001). The CSA of the SCV was significantly different, depending on shoulder positions (neutral vs. lowered: 0.44 cm2, 95% CI, 0.33 to 0.54; Pcorrected < 0.001), and body position (supine vs. Trendelenburg: −0.15 cm2, 95% CI, −0.19 to −0.12; Pcorrected < 0.001). However, the depth of the SCV did not differ with respect to head, shoulder, and body positions.
Ipsilateral 30° head rotation, neutral shoulder position, and Trendelenburg position significantly enhanced the CSA of the SCV in obese participants.</description><subject>Adult</subject><subject>Body Mass Index</subject><subject>Catheterization, Central Venous</subject><subject>Catheters</subject><subject>Cross-sectional area</subject><subject>Emergency medical care</subject><subject>Female</subject><subject>Head</subject><subject>Head-Down Tilt</subject><subject>Humans</subject><subject>Intubation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Obese</subject><subject>Obesity</subject><subject>Obesity - diagnostic imaging</subject><subject>Patient Positioning</subject><subject>Patients</subject><subject>Pneumothorax</subject><subject>Shoulder</subject><subject>Skin</subject><subject>Subclavian vein</subject><subject>Subclavian Vein - diagnostic imaging</subject><subject>Supine Position</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography</subject><subject>Ultrasound</subject><subject>Variance analysis</subject><subject>Veins & arteries</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kUtr3DAUhUVpaKZp_0AXRdBNN3Z0Jeth6KaE9AGBbpK1kOXrjozHmkr2QP995EzaRRcFwQXd7xy45xDyDlgNDNT1WLsRDzVnHGpmagbiBdmBFLwyoOEl2TEtZKW01Jfkdc4jYwCNbF6RS9FIKZViOzLdDgP6hcaB7tH11M09zfu4Tj0meow5LCHOYf5J40yXPVKfYs5VLpLy7ybqErpNvO3y2vnJnYKb6QnDTMuLHeanxVgU-Q25GNyU8e3zvCIPX27vb75Vdz--fr_5fFd5IeRSGSG9b7sBROMlU4Z7L7hkHrlgnQHoTNsMgxZN33Y4OK05CMaNlgiatwDiinw8-x5T_LViXuwhZI_T5GaMa7ZcaqWkMtIU9MM_6BjXVC4rlGKN4dAqUSh-pp7OTzjYYwoHl35bYHbrwo5268JuXVhmbOmiiN4_W6_dAfu_kj_hF-DTGcCSxSlgstkHnD32IZW4bB_D__wfAZ53mXQ</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Kim, Hyerim</creator><creator>Chang, Jee-Eun</creator><creator>Won, Dongwook</creator><creator>Lee, Jung-Man</creator><creator>Kim, Tae Kyong</creator><creator>Min, Seong-Won</creator><creator>Kim, Chanho</creator><creator>Hwang, Jin-Young</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>202112</creationdate><title>Effect of head and shoulder positioning on the cross-sectional area of the subclavian vein in obese subjects</title><author>Kim, Hyerim ; Chang, Jee-Eun ; Won, Dongwook ; Lee, Jung-Man ; Kim, Tae Kyong ; Min, Seong-Won ; Kim, Chanho ; Hwang, Jin-Young</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c335t-835cc9bf134c50682cc3250ce230b811b894ff734d9befa7721302875e1729113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Body Mass Index</topic><topic>Catheterization, Central Venous</topic><topic>Catheters</topic><topic>Cross-sectional area</topic><topic>Emergency medical care</topic><topic>Female</topic><topic>Head</topic><topic>Head-Down Tilt</topic><topic>Humans</topic><topic>Intubation</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Obese</topic><topic>Obesity</topic><topic>Obesity - diagnostic imaging</topic><topic>Patient Positioning</topic><topic>Patients</topic><topic>Pneumothorax</topic><topic>Shoulder</topic><topic>Skin</topic><topic>Subclavian vein</topic><topic>Subclavian Vein - diagnostic imaging</topic><topic>Supine Position</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography</topic><topic>Ultrasound</topic><topic>Variance analysis</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Hyerim</creatorcontrib><creatorcontrib>Chang, Jee-Eun</creatorcontrib><creatorcontrib>Won, Dongwook</creatorcontrib><creatorcontrib>Lee, Jung-Man</creatorcontrib><creatorcontrib>Kim, Tae Kyong</creatorcontrib><creatorcontrib>Min, Seong-Won</creatorcontrib><creatorcontrib>Kim, Chanho</creatorcontrib><creatorcontrib>Hwang, Jin-Young</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Hyerim</au><au>Chang, Jee-Eun</au><au>Won, Dongwook</au><au>Lee, Jung-Man</au><au>Kim, Tae Kyong</au><au>Min, Seong-Won</au><au>Kim, Chanho</au><au>Hwang, Jin-Young</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of head and shoulder positioning on the cross-sectional area of the subclavian vein in obese subjects</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>2021-12</date><risdate>2021</risdate><volume>50</volume><spage>561</spage><epage>565</epage><pages>561-565</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><abstract>Head and shoulder positioning may affect cross-sectional area (CSA) and location of the subclavian vein (SCV). We investigated the CSA of the SCV and the depth of the SCV, depending on the head and shoulder positions.
In 24 healthy obese volunteers, the short axis ultrasound images of the SCV and adjacent structures were obtained in three different head positions (neutral, 30° turned to the contralateral side, and 30° turned to the ipsilateral side) and two different shoulder positions (neutral and lowered). Images of the right and left SCVs were obtained in the supine and Trendelenburg positions. Subsequently, the CSA and depth of the SCV were measured.
Significant differences were found in the CSA of the SCV in different head positions (30° turned to contralateral side vs. neutral: −0.06 cm2, 95% confidence interval [CI], −0.10 to −0.02; Pcorrected = 0.002, 30° turned to contralateral side vs. 30° turned to ipsilateral side: −0.16 cm2, 95% CI, −0.22 to −0.11; Pcorrected < 0.001, Neutral vs. 30° turned to ipsilateral side: −0.10 cm2, 95% CI, −0.14 to −0.07; Pcorrected < 0.001). The CSA of the SCV was significantly different, depending on shoulder positions (neutral vs. lowered: 0.44 cm2, 95% CI, 0.33 to 0.54; Pcorrected < 0.001), and body position (supine vs. Trendelenburg: −0.15 cm2, 95% CI, −0.19 to −0.12; Pcorrected < 0.001). However, the depth of the SCV did not differ with respect to head, shoulder, and body positions.
Ipsilateral 30° head rotation, neutral shoulder position, and Trendelenburg position significantly enhanced the CSA of the SCV in obese participants.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34555660</pmid><doi>10.1016/j.ajem.2021.08.013</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Body Mass Index Catheterization, Central Venous Catheters Cross-sectional area Emergency medical care Female Head Head-Down Tilt Humans Intubation Male Middle Aged Obese Obesity Obesity - diagnostic imaging Patient Positioning Patients Pneumothorax Shoulder Skin Subclavian vein Subclavian Vein - diagnostic imaging Supine Position Ultrasonic imaging Ultrasonography Ultrasound Variance analysis Veins & arteries |
| title | Effect of head and shoulder positioning on the cross-sectional area of the subclavian vein in obese subjects |
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