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Title

Impact of Trendelenburg positioning on functional residual capacity and ventilation homogeneity in anaesthetised children

Authors
Erb, TO
Von Ungern-Sternberg, BS
Published in Anaesthesia. 2007, vol. 62, no. 5, p. 451-5
Abstract 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.
Keywords Anesthesia, General/methodsCatheterization, Central Venous/methodsChildChild, PreschoolFunctional Residual Capacity/physiologyHead-Down Tilt/physiologyHeart Defects, Congenital/surgeryHumansInfantPulmonary Gas Exchange/physiologySupine Position/physiology
Identifiers
PMID: 17448055
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Article (Published version) (479 Kb) - document accessible for UNIGE members only Limited access to UNIGE
Structures
Research group Enfants et hyperréactivité bronchique (69)
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(ISO format)
REGLI, Adrian et al. Impact of Trendelenburg positioning on functional residual capacity and ventilation homogeneity in anaesthetised children. In: Anaesthesia, 2007, vol. 62, n° 5, p. 451-5. https://archive-ouverte.unige.ch/unige:44509

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Deposited on : 2015-01-06

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