{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:19:21Z","timestamp":1747196361511,"version":"3.40.5"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T00:00:00Z","timestamp":1682553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>The role of positive endexpiratory pressure (PEEP) for successful cannulation of the subclavian vein (SCV) remains inconclusive. The aim of our study was to assess the effect of different levels of PEEP on distance from SCV to parietal pleura (DVP) and on the cross-sectional area (CSA) of the SCV.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Invasive mechanically ventilated adult patients with a clinical indication for a stepwise PEEP-trial (0, 5, 10, and 15 cm H<jats:sub>2<\/jats:sub>O) were included in this prospective observational single-center study. Ultrasound examinations of SCV were performed with a linear ultrasound probe using the infraclavicular view. DVP and CSA were measured on the right and left bodyside. Examinations were repeated at each PEEP step.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>27 patients were enrolled (12 female; 60\u00b121 years; BMI 24.6\u00b14.9 kg\/m<jats:sup>2<\/jats:sup>; 20 patients on controlled, 7 on assisted ventilation). A statistically significant increase of DVP in the in-plane view was found on the left side which was not clinically relevant. No significant differences of DVP were observed in all other views. PEEP induced changes in CSAs were statistically significant but clinically not relevant on both sides. The largest change in CSA (2mm<jats:sup>2<\/jats:sup>) was observed when comparing PEEP 10 with PEEP 0 cm H<jats:sub>2<\/jats:sub>O.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>A stepwise PEEP increase was not associated with clinically relevant changes of the DVP and CSA. Thus, a PEEP-optimization for the cannulation of the subclavian vein is not indicated.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0285110","type":"journal-article","created":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T17:36:06Z","timestamp":1682616966000},"page":"e0285110","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["The role of PEEP for cannulation of the subclavian vein: A prospective observational study"],"prefix":"10.1371","volume":"18","author":[{"given":"Christine","family":"Eimer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Knut G.","family":"Rump","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gunnar","family":"Elke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias H.","family":"Becher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Weiler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amke","family":"Caliebe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5745-4797","authenticated-orcid":true,"given":"Dirk","family":"Sch\u00e4dler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,4,27]]},"reference":[{"issue":"4","key":"pone.0285110.ref001","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1007\/s00134-019-05564-7","article-title":"Ultrasound-guided vascular access in critical illness","volume":"45","author":"GA Schmidt","year":"2019","journal-title":"Intensive Care Med"},{"issue":"1","key":"pone.0285110.ref002","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1177\/1129729819852204","article-title":"Dynamic variation of the axillary veins due to intrathoracic pressure changes: A prospective sonographic study","volume":"21","author":"B Tufegdzic","year":"2020","journal-title":"J Vasc Access"},{"issue":"1","key":"pone.0285110.ref003","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1213\/ANE.0b013e31826257f4","article-title":"The effect of full expiration on the position and size of the subclavian vein in spontaneously breathing adults","volume":"117","author":"KJ Lim","year":"2013","journal-title":"Anesth Analg"},{"key":"pone.0285110.ref004","unstructured":"R Core Team: R: A language and environment for statistical computing. 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