Positive end-expiratory pressure to increase internal jugular vein size is poorly tolerated in obese anesthetized adults

Laura A. Downey, Kevin P. Blaine, Jan Sliwa, Alex MacArio, John Brock-Utne

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

BACKGROUND:: 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. METHODS:: 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. RESULTS:: 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). CONCLUSIONS:: PEEP modestly increases the size of the IJV in obese adults but was poorly tolerated because of hypotension.

Original languageEnglish (US)
Pages (from-to)619-621
Number of pages3
JournalAnesthesia and analgesia
Volume119
Issue number3
DOIs
StatePublished - 2014
Externally publishedYes

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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