Clinical trial NCT01401920: The Influence of Passive Leg Elevation on the Cross-sectional Area of the Internal Jugular Vein in Infants or Young Children Undergoing Open Heart Surgery
Official title: The Influence of Passive Leg Elevation on the Cross-sectional Area of the Internal Jugular Vein in Infants or Young Children Undergoing Open Heart Surgery
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Infants or Children Undergoing Open Heart Surgery
Keywords: internal jugular vein cannulation
cross-sectional area
passive leg elevation
trendelenburg position
open heart surgery
Lead sponsor: Samsung Medical Center
Sponsor class: OTHER
First posted: 2011-07-25
Enrollment: 90
Sex: ALL
Maximum age (years): 5
Standard ages: CHILD
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: infants or children undergoing open heart surgery for congenital anomaly for study period

Brief summary: The trendelenburg position is usually applied to increase the cross-sectional area of the IJV. However, trendelenburg position requires a tilt table to place the head in the down position. Trendelenburg position could also increase intracranial pressure. Passive leg elevation redistributes more blood from the lower extremity into the central veins and is proved to increase the cross-sectional area of IJV in adults. However, the effect of leg elevation on the cross-sectional area of IJV in small infants and children has not been evaluated.

The investigators evaluated the effect of passive leg elevation on the cross-sectional area of IJV in subjects undergoing open heart surgery for congenital anomaly.

Detailed description: Internal jugular vein (IJV) cannulation is essential for open heart surgery of small infants and children for transfusion or inotropics infusion. The trendelenburg position is usually applied to increase the cross-sectional area of the IJV.

However, trendelenburg position requires a tilt table to place the head in the down position. Trendelenburg position could also increase intracranial pressure. Passive leg elevation redistributes more blood from the lower extremity into the central veins and is proved to increase the cross-sectional area of IJV in adults. However, the effect of leg elevation on the cross-sectional area of IJV in small infants and children has not been evaluated. Furthermore, the children undergoing open heart surgery due to cardiac anomaly have an altered hemodynamics and often congested right heart. Therefore, the response of passive leg elevation may be different from that of normal heart physiology. Therefore, we evaluated the effect of passive leg elevation on the cross-sectional area of IJV in subjects undergoing open heart surgery for congenital anomaly.

Eligibility criteria: Inclusion Criteria:

* infants or children under 5 yrs undergoing elective open heart surgery for congenital anomaly for study period

Exclusion Criteria:

* previous history of internal jugular vein cannulation
* concurrent pulmonary disease that can influence the hemodynamics of right heart
* increased intracranial pressure
* hemodynamic unstability

Primary outcomes:
measure: Cross-sectional area of internal jugular vein
timeFrame: one time measurement 10 min before jugular vein cannulation
Secondary outcomes:
measure: Transverse diameter of internal jugular vein
timeFrame: only one time measurements 10 min before internal jugular vein cannulation
measure: horizontal diameter of internal jugular vein
timeFrame: only one time measurements 10 min before jugular vein cannulation
measure: skin to internal jugular vein depth
timeFrame: one time measurement 10 min before jugular vein cannulation
Other outcomes:
Locations:
city: Seoul
country: Korea, Republic of
facility: Samsung Medical Center
Study officials:
affiliation: Samsung Medical Center
name: Chung Su Kim, M.D.,Ph.D.
role: PRINCIPAL_INVESTIGATOR
References: