The Trendelenburg position is a body position where the person lies flat on their back (supine) on an incline of approximately 15 to 30 degrees, with the feet elevated higher than the head. This positioning causes the body to tilt so that the head is lower than the feet.
Medical Uses
- It is commonly used in surgery, especially abdominal and pelvic surgeries, to improve access by moving the organs upward with gravity.
- It can assist in placing central venous catheters in the internal jugular or subclavian veins by distending the veins.
- The position is sometimes used in emergencies for hypotension to help increase blood flow to the heart and brain.
- It is used during certain procedures like the treatment of venous air embolism and in respiratory patients to improve perfusion.
Physiological Effects and Cautions
- It increases venous return, cardiac output (temporarily), central venous pressure, and systemic vascular resistance.
- Prolonged positioning can lead to respiratory compromise, increased intracranial and intraocular pressures, airway and facial edema, and risk of nerve injuries from pressure.
- Not recommended in patients with obesity, intracranial hypertension, or head trauma due to these risks.
Variations
- The reverse Trendelenburg position is the opposite tilt, with the head elevated higher than the feet, used for different surgical and medical purposes like reducing blood loss in head or neck surgery or relieving gastroesophageal reflux.
The Trendelenburg position is named after Friedrich Trendelenburg, a German surgeon who popularized its use in the 19th century.