Assessment of internal diameter and cross-sectional area of right internal jugular vein pre-induction and post-intubation.

This prospective observational study compared the internal diameter and cross-sectional area of the right internal jugular vein pre-induction and post-initiation of positive pressure ventilation. Twenty patients undergoing coronary artery bypass surgery were studied. Measurements were taken with the operating table tipped to 30 degrees head down and the head turned 10 degrees away from the side of cannulation. There was a statistically significant increase in both measurements post-intubation. This study suggests that it may be easier and safer to perform cannulation of RIJV after institution of intermittent positive pressure ventilation in patients in the modified Trendelenburg position.