title: The Influence of Arm Positioning on Ultrasonic Visualization of the Subclavian Vein: An Anatomical Ultrasound Study in Healthy Volunteers.
abstract: We hypothesized that placing the arm in 90° abduction, through 90° flexion and 90° external rotation, could improve ultrasound visualization of the subclavian vein. In 49 healthy volunteers, a single operator performed a view of the subclavian vein in neutral position and abduction position. A second blinded operator measured the cross-sectional area of the subclavian vein. Abduction position increased the cross-sectional area of the subclavian vein from 124 ± 46 (mean ± SD) to 162 ± 58 mm (P = 0.001). An increase of the cross-sectional area of ≥50% was observed in 41% volunteers (95% confidence interval, 27%-56%, n = 20); this technique offers an alternative approach (maybe safer) for ultrasound-guided catheterization of the subclavian vein.
authors.affiliation: From the *Division of Anaesthesiology, Critical Care, Pain and Emergency Medicine, Nîmes University Hospital, Nîmes, France; †Department of Anaesthesia and Critical Care Medicine, Montpellier University Hospital - Hôpital Arnaud de Villeneuve, Montpellier, France; ‡Nîmes Faculty of Medicine, Montpellier University, Nîmes, France; §Department of Biostatistics and Clinical Epidemiology, Nîmes University Hospital, Nîmes, France; and ∥Department of Cardiology, Nîmes University Hospital, Nîmes, France.
authors.forename: Meriem
authors.initials: M
authors.lastname: Sadek
authors.forename: Claire
authors.initials: C
authors.lastname: Roger
authors.forename: Sophie
authors.initials: S
authors.lastname: Bastide
authors.forename: Pascal
authors.initials: P
authors.lastname: Jeannes
authors.forename: Kamila
authors.initials: K
authors.lastname: Solecki
authors.forename: Audrey
authors.initials: A
authors.lastname: de Jong
authors.forename: Gautier
authors.initials: G
authors.lastname: Buzançais
authors.forename: Loubna
authors.initials: L
authors.lastname: Elotmani
authors.forename: Jacques
authors.initials: J
authors.lastname: Ripart
authors.forename: Jean Yves
authors.initials: JY
authors.lastname: Lefrant
authors.forename: Xavier
authors.initials: X
authors.lastname: Bobbia
authors.forename: Laurent
authors.initials: L
authors.lastname: Muller
mesh_terms: D000328:Adult; D059925:Anatomic Landmarks; D001132:Arm / Q000098:blood supply*; D001696:Biomechanical Phenomena; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D056888:Patient Positioning; D011237:Predictive Value of Tests; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D013350:Subclavian Vein / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D055815:Young Adult