Notice: Users may be experiencing issues with displaying some pages on stanfordhealthcare.org. We are working closely with our technical teams to resolve the issue as quickly as possible. Thank you for your patience.
 

Learn about the flu shot, COVID-19 vaccine, and our masking policy »

Stanford Health Care

Positive end-expiratory pressure to increase internal jugular vein size is poorly tolerated in obese anesthetized adults. Anesthesia and analgesia Downey, L. A., Blaine, K. P., Sliwa, J., Macario, A., Brock-Utne, J. 2014; 119 (3): 619-621

Abstract

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.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.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).PEEP modestly increases the size of the IJV in obese adults but was poorly tolerated because of hypotension.

View details for DOI 10.1213/ANE.0000000000000347

View details for PubMedID 25137000