Effect of passive leg raising on the cross-sectional area of the right internal jugular vein in patients with obesity: a randomised controlled trial protocol

• Published in: BMJ open Vol. 14; no. 5; p. e085044
• Main Authors: Pei, Dongliang, Wang, Shuyan, Sun, Chenmin
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 06.05.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: ACCIDENT & EMERGENCY MEDICINE; Adult; Adult anaesthesia; Adult intensive & critical care; Anaesthesia; Body mass index; Catheterization, Central Venous - methods; Elective surgery; Female; Humans; Jugular Veins - diagnostic imaging; Leg - blood supply; Leg - diagnostic imaging; Male; Obesity; Obesity - therapy; Patient Positioning - methods; Patients; Performance evaluation; Randomized Controlled Trials as Topic; Software; Success; Ultrasonic imaging; Ultrasonography; Veins & arteries; Obesity; Adult anaesthesia; ACCIDENT & EMERGENCY MEDICINE; Adult intensive & critical care
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2024-085044

BackgroundVenous access in patients with obesity presents significant challenges. The success of central venous catheterisation largely depends on the cross-sectional area (CSA) of the internal jugular vein (IJV). While techniques like the Trendelenburg position have been traditionally used to increase IJV CSA, recent studies suggest its ineffectiveness in patients with obesity. Conversely, the potential of the effect of passive leg raising (PLR) has not been thoroughly investigated in this group of patients.MethodsThis protocol outlines a planned randomised controlled trial to evaluate the effect of PLR on the CSA of the IJV in patients with obesity slated for central venous catheterisation. The protocol involves dividing 40 participants into two groups: one undergoing PLR and another serving as a control group without positional change. The protocol specifies measuring the CSA of the IJV via ultrasound as the primary outcome. Secondary outcomes will include the success rates of right IJV cannulation. The proposed statistical approach includes the use of t-tests to compare the changes in CSA between the two groups, with a significance threshold set at p<0.05.Ethics approvalThis study has been approved by the Institutional Review Board of Shanghai Tongren Hospital. All the participants will provide informed consent prior to enrolment in the study. Regarding the dissemination of research findings, we plan to share the results through academic conferences and peer-reviewed publications. Additionally, we will communicate our findings to the public and professional communities, including patient advocacy groups.Trial registration numberChiCTR: ChiCTR2400080513.