Trendelenburg position

1. Trendelenburg PositionTrendelenburg Position

2. Supine with the feet higher than head by Supine with the feet higher than head by
15° - 30°.15° - 30°.

3. History History
Friedrich Trendelenburg created the Friedrich Trendelenburg created the
position . position .
Walter Cannon - used for shock. Walter Cannon - used for shock.
A decade later, Cannon reversed his A decade later, Cannon reversed his
opinion but that did not deter its opinion but that did not deter its
widespread use. widespread use.

4. usesuses
Insertion or removal of central venous Insertion or removal of central venous
catheters .catheters .
Certain spinal anaesthetic techniques .Certain spinal anaesthetic techniques .
Pelvic and gynaecologic surgery.Pelvic and gynaecologic surgery.
Abdominal hernia reduction.Abdominal hernia reduction.
Delivery - cord prolapse .Delivery - cord prolapse .

5. Not indicated or may have harmful Not indicated or may have harmful
effects in effects in
Resuscitation in hypotension/shock .Resuscitation in hypotension/shock .
Difficult mechanical . Difficult mechanical .
Decreased vital capacity.Decreased vital capacity.
Increased intracranial Increased intracranial
pressure/ intraocular pressure .pressure/ intraocular pressure .
Cerebral oedema.Cerebral oedema.
Lower limbs ischaemia. Lower limbs ischaemia.

6. Complications ( esp. in Complications ( esp. in
hypotension)hypotension)
Anxiety .Anxiety .
Hypoventilation and atelectasis .Hypoventilation and atelectasis .
Altered V/Q ratios .Altered V/Q ratios .
Increased intracranial pressure .Increased intracranial pressure .
Decreased cardiac output and Decreased cardiac output and
hypotension.hypotension.
Risk of aspiration .Risk of aspiration .

7. Current data to support the use of the Current data to support the use of the
Trendelenburg position during shock are Trendelenburg position during shock are
limited and do not reveal any beneficial or limited and do not reveal any beneficial or
sustained changes in systolic blood sustained changes in systolic blood
pressure or cardiac output. pressure or cardiac output.

8. Use/not useUse/not use
““It is the mark of an educated mind to be It is the mark of an educated mind to be
able to entertain a thought without able to entertain a thought without
accepting it”.accepting it”.
AristotleAristotle