The patient's position influences the incidence of dysrhythmias during pulmonary artery catheterization

D. J. Keusch, Stephen Winters, D. M. Thys

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

To determine the influence of a patient's position on the incidence of dysrhythmias during pulmonary artery catheterization, 34 adult patients scheduled for elective coronary artery bypass graft surgery and pulmonary artery catheterization were studied. All introducers were inserted via the right internal jugular vein using the Seldinger technique with the patient in the Trendelenburg position. For each patient, the pulmonary artery catheter was advanced twice: once while the patient was in the Trendelenburg (T) position with a 5-10° head-down tilt and antoher with a 5° head-up and right lateral tilt (R) position. In 13 of the 68 pulmonary artery catheter passages, no dysrhythmias were noted. In 13 patients, a change in dysrhythmia classification was noted between the two positions. In 11 of the 13 patients, the dysrhythmia classification changed from malignant in the Trendelenburg position to benign or absent in the right lateral tilt position. Although the incidence of dysrhythmias was similar in both groups, the Trendelenburg position was associated with a significantly higher incidence of malignant dysrhythmias than the right tilt position (P < 0.05). The authors conclude that the head-up and right lateral tilt position appears superior to the Trendelenburg position for passage of the pulmonary artery catheter in the awake patient scheduled for elective coronary bypass surgery.

Original languageEnglish (US)
Pages (from-to)582-584
Number of pages3
JournalAnesthesiology
Volume70
Issue number4
DOIs
StatePublished - Jan 1 1989
Externally publishedYes

Fingerprint

Swan-Ganz Catheterization
Head-Down Tilt
Incidence
Pulmonary Artery
Catheters
Head
Jugular Veins
Coronary Artery Bypass
Transplants

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

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abstract = "To determine the influence of a patient's position on the incidence of dysrhythmias during pulmonary artery catheterization, 34 adult patients scheduled for elective coronary artery bypass graft surgery and pulmonary artery catheterization were studied. All introducers were inserted via the right internal jugular vein using the Seldinger technique with the patient in the Trendelenburg position. For each patient, the pulmonary artery catheter was advanced twice: once while the patient was in the Trendelenburg (T) position with a 5-10° head-down tilt and antoher with a 5° head-up and right lateral tilt (R) position. In 13 of the 68 pulmonary artery catheter passages, no dysrhythmias were noted. In 13 patients, a change in dysrhythmia classification was noted between the two positions. In 11 of the 13 patients, the dysrhythmia classification changed from malignant in the Trendelenburg position to benign or absent in the right lateral tilt position. Although the incidence of dysrhythmias was similar in both groups, the Trendelenburg position was associated with a significantly higher incidence of malignant dysrhythmias than the right tilt position (P < 0.05). The authors conclude that the head-up and right lateral tilt position appears superior to the Trendelenburg position for passage of the pulmonary artery catheter in the awake patient scheduled for elective coronary bypass surgery.",
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The patient's position influences the incidence of dysrhythmias during pulmonary artery catheterization. / Keusch, D. J.; Winters, Stephen; Thys, D. M.

In: Anesthesiology, Vol. 70, No. 4, 01.01.1989, p. 582-584.

Research output: Contribution to journalArticle

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