The Effects of Positioning on the Volume/Location of the Internal Jugular Vein Using 2-Dimensional Tracked Ultrasound

• Published in: Journal of cardiothoracic and vascular anesthesia 2020-04, Vol.34 (4), p.920-925
• Main Authors: Wang, Wanyu, Liao, Xinyang, Chen, Elvis C.S., Moore, John, Baxter, John S.H., Peters, Terry M., Bainbridge, Daniel
• Format: Article
• Language: English
• Subjects: 2-dimensional tracked ultrasound; Catheterization, Central Venous; head positioning; Head-Down Tilt; Humans; internal jugular vein; Jugular Veins - diagnostic imaging; location; Prospective Studies; Trendelenburg position; Ultrasonography; volume
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2019.08.049

To investigate the effects of different positioning on the volume/location of the internal jugular vein (IJV) using 2-dimensional (2D) tracked ultrasound. This was a prospective, observational study. Local research institute. Healthy volunteers. Twenty healthy volunteers were scanned in the following 6 positions: (1) supine with head neutral, rotated 15 and 30 degrees to the left and (2) 5-, 10-, and 15-degree Trendelenburg position with head neutral. In each position the volunteer's neck was scanned using a 2D ultrasound probe tracked with a magnetic tracker. These spatially tracked 2D images were collected and reconstructed into a 3D volume of the IJV and carotid artery. This 3D ultrasound volume then was segmented to obtain a 3D surface on which measurements and calculations were performed. The measurements included average cross-section area (CSA), CSA along the length of IJV, and average overlap rate. CSA (mm2) in the supine and 5-, 10-, and 15-degree Trendelenburg positions were as follows: 86.7 ± 44.8, 104.3 ± 54.5, 119.1 ± 58.6, and 133.7 ± 53.3 (p < 0.0001). CSA enlarged with the increase of Trendelenburg degree. Neither Trendelenburg position nor head rotation showed a correlation with overlap rate. Trendelenburg position significantly increased the CSA of the IJV, thus facilitating IJV cannulation. This new 3D reconstruction method permits the creation of a 3D volume through a tracked 2D ultrasound scanning system with image acquisition and integration and may prove useful in providing the user with a “road map” of the vascular anatomy of a patient's neck or other anatomic structures.