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British Journal of Anaesthesia, 2002, Vol. 89, No. 5 769-771
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Short Communications

Effects of prolonged head-down tilt on internal jugular vein cross-sectional area

S. J. Schreiber*, U. K. W. Lambert, F. Doepp and J. M. Valdueza

Department of Neurology, University Hospital Charité, Schumannstrasse 20/21, D-10098 Berlin, Germany*Corresponding author

Background. Head-down tilt is often used to assist cannulation of the internal jugular vein (IJV). However, the optimal duration of tilt before cannulation is not well defined.

Methods. Fifteen healthy volunteers were studied by B-mode duplex sonography to assess changes in cross-sectional area (CSA) of the right IJV during 10° head-down tilt.

Results. Median CSA in the supine position was 102 mm2 [range 16–266, mean (SD) 113 (69)]. CSA increased to 139 mm2 [23–388, 158 (93)] immediately after tilting (P<0.0001, repeated measures ANOVA). No significant further change was noted in the next 20 min. CSA returned to baseline level after return to the supine position.

Conclusion. The 10° head-down tilt manoeuvre in healthy volunteers causes an immediate, significant increase in CSA in the right IJV. A longer tilt did not cause further increase in jugular CSA.

Br J Anaesth 2002; 89: 769–71


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