Optimale positie van de patiënt bij katheterisatie van de V. subclavia: in trendelenburgligging, zonder rol tussen de schouderbladen.

OBJECTIVE: To determine the optimal patient position for subclavian-vein catheterisation. DESIGN: Descriptive. METHOD: The anteroposterior diameter of the right and left subclavian vein was measured using B-mode ultrasound in 26 healthy volunteers lying in 4 different positions: horizontally with or without a rolled towel between the should blades, or in the Trendelenburg position with or without a rolled towel. RESULTS: The mean diameter of the subclavian vein was 10.7 mm. There was a statistically significant association between the diameter of the vein and the position of the volunteer, the use of the rolled towel, and the side of the body. The least favourable results were obtained on the left side when the patient was lying horizontally with a rolled towel (8.65 mm). The most favourable results were obtained on the right side when the patient was in the Trendelenburg position without a rolled towel (12.05 mm). CONCLUSION: For successful catheterisation of the subclavian vein, the patient should be placed in the Trendelenburg position without a rolled towel between the shoulder blades, and the puncture should be preferably on the right side.