Tongren Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China
Tongren Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China.
BMJ Open. 2024 May 6;14(5):e085044. doi: 10.1136/bmjopen-2024-085044.
Venous access in patients with obesity presents significant challenges. The success of central venous catheterisation largely depends on the cross-sectional area (CSA) of the internal jugular vein (IJV). While techniques like the Trendelenburg position have been traditionally used to increase IJV CSA, recent studies suggest its ineffectiveness in patients with obesity. Conversely, the potential of the effect of passive leg raising (PLR) has not been thoroughly investigated in this group of patients.
This protocol outlines a planned randomised controlled trial to evaluate the effect of PLR on the CSA of the IJV in patients with obesity slated for central venous catheterisation. The protocol involves dividing 40 participants into two groups: one undergoing PLR and another serving as a control group without positional change. The protocol specifies measuring the CSA of the IJV via ultrasound as the primary outcome. Secondary outcomes will include the success rates of right IJV cannulation. The proposed statistical approach includes the use of t-tests to compare the changes in CSA between the two groups, with a significance threshold set at p<0.05.
This study has been approved by the Institutional Review Board of Shanghai Tongren Hospital. All the participants will provide informed consent prior to enrolment in the study. Regarding the dissemination of research findings, we plan to share the results through academic conferences and peer-reviewed publications. Additionally, we will communicate our findings to the public and professional communities, including patient advocacy groups.
ChiCTR: ChiCTR2400080513.
肥胖患者的静脉通路建立存在显著挑战。中心静脉导管置管的成功率在很大程度上取决于颈内静脉(IJV)的横截面积(CSA)。虽然传统上采用头低位等技术来增加 IJV CSA,但最近的研究表明,这些技术在肥胖患者中效果不佳。相反,被动抬腿(PLR)对这组患者的影响潜力尚未得到充分研究。
本方案概述了一项计划中的随机对照试验,旨在评估 PLR 对肥胖患者中心静脉导管置管时 IJV CSA 的影响。该方案将 40 名参与者分为两组:一组进行 PLR,另一组作为不改变体位的对照组。方案规定通过超声测量 IJV CSA 作为主要结局。次要结局将包括右侧 IJV 穿刺成功率。拟采用 t 检验比较两组 CSA 的变化,以 p<0.05 为显著性阈值。
本研究已获得上海交通大学附属同仁医院机构审查委员会的批准。所有参与者在入组前均将提供知情同意。关于研究结果的传播,我们计划通过学术会议和同行评审出版物分享研究结果。此外,我们将向公众和专业社区,包括患者权益组织,传达我们的发现。
ChiCTR:ChiCTR2400080513。