{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:33:38Z","timestamp":1786977218963,"version":"build-2736575974"},"reference-count":44,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T00:00:00Z","timestamp":1650326400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Most guidelines fail to specify patient positioning during central venous catheterization. The objective was to determine the effects of head\u2010down tilt (Trendelenburg position) and head rotation on the internal jugular vein (IJV). A prospective, observational, longitudinal, and descriptive study using healthy adult volunteers, of both sexes, was performed. The change in position and cross\u2010sectional areas (CSA) of the right IJV and common carotid artery (CA) were measured by ultrasonography during Trendelenburg position (TP) (0\u00b0, 5\u00b0, 10\u00b0, and 15\u00b0) and contralateral head\u2010rotation (HR) (0\u00b0, 45\u00b0, and 90\u00b0) for a total of 12 positions. The neutral supine position was first, randomizing the other 11 positions, with 5\u2010min rest intervals in between. Vital signs and symptoms were recorded. A total of 54 volunteers were recruited between the ages of 21 and 32, of which 30 were men. Any degree of TP or HR significantly increased the CSA. The largest area obtained was 1.78\u2009cm\n                    <jats:sup>2<\/jats:sup>\n                    with a TP15HR90 which did not have a statistical difference with TP10HR45 1.59\u2009cm\n                    <jats:sup>2<\/jats:sup>\n                    . A HR90 tended to displace the IJV medially, overlaying the CA. Any degree of TP or HR will significantly increase CSA or the right IJV. A 5\u00b0 to 10\u00b0 TP is recommended when the patient's condition allows it, with a 45\u00b0 HR, without significantly displacing the IJV anterior to the CCA.\n                  <\/jats:p>","DOI":"10.1002\/ca.23884","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T23:05:16Z","timestamp":1649718316000},"page":"883-890","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Trendelenburg (\n                    <scp>Head\u2010Down<\/scp>\n                    tilt) and head rotation: Ultrasonographic effects on the internal jugular vein for catheterization safety"],"prefix":"10.1002","volume":"35","author":[{"given":"Yenitzeh Ana Karen","family":"Hern\u00e1ndez\u2010Garate","sequence":"first","affiliation":[{"name":"School of Medicine, Human Anatomy Department Universidad Autonoma de Nuevo Leon  Monterrey Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo Enrique","family":"Elizondo\u2010Oma\u00f1a","sequence":"additional","affiliation":[{"name":"School of Medicine, Human Anatomy Department Universidad Autonoma de Nuevo Leon  Monterrey Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio Alberto","family":"Casas\u2010Murillo","sequence":"additional","affiliation":[{"name":"University Hospital \u201cDr. Jose Eleurterio Gonzalez\u201d, Radiology and Imaging Department Universidad Autonoma de Nuevo Leon  Monterrey Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ra\u00fal Antonio","family":"de Luna\u2010Vega","sequence":"additional","affiliation":[{"name":"University Hospital \u201cDr. Jose Eleurterio Gonzalez\u201d, Radiology and Imaging Department Universidad Autonoma de Nuevo Leon  Monterrey Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Elizondo\u2010Riojas","sequence":"additional","affiliation":[{"name":"University Hospital \u201cDr. Jose Eleurterio Gonzalez\u201d, Radiology and Imaging Department Universidad Autonoma de Nuevo Leon  Monterrey Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolanda","family":"Salinas\u2010Alvarez","sequence":"additional","affiliation":[{"name":"School of Medicine, Human Anatomy Department Universidad Autonoma de Nuevo Leon  Monterrey Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo Alfonso","family":"Fernandez\u2010Rodarte","sequence":"additional","affiliation":[{"name":"School of Medicine, Human Anatomy Department Universidad Autonoma de Nuevo Leon  Monterrey Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4100-1360","authenticated-orcid":false,"given":"Santos","family":"Guzman\u2010Lopez","sequence":"additional","affiliation":[{"name":"School of Medicine, Human Anatomy Department Universidad Autonoma de Nuevo Leon  Monterrey Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5398-247X","authenticated-orcid":false,"given":"Alejandro","family":"Quiroga\u2010Garza","sequence":"additional","affiliation":[{"name":"School of Medicine, Human Anatomy Department Universidad Autonoma de Nuevo Leon  Monterrey Mexico"},{"name":"Instituto Mexicano del Seguro Social Delegaci\u00f3n de Nuevo Leon Monterrey  Monterrey Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1994.tb03879.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2005.11.005"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2008.03.034"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1067\/msy.1999.98735"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181a067d4"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2015.12.034"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.accpm.2015.01.004"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.11622\/smedj.2015020"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12295"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211031339"},{"key":"e_1_2_6_12_1","unstructured":"Heffner A. 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