The Influence of Arm Positioning on Ultrasonic Visualization of the Subclavian Vein: An Anatomical Ultrasound Study in Healthy Volunteers.

We hypothesized that placing the arm in 90[degrees] abduction, through 90[degrees] flexion and 90[degrees] 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 mm2 (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. (C) 2016 International Anesthesia Research Society

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