トレンデレンブルグ位
WordNet
- cause to be in an appropriate place, state, or relation
- a job in an organization; "he occupied a post in the treasury" (同)post, berth, office, spot, billet, place, situation
- the arrangement of the body and its limbs; "he assumed an attitude of surrender" (同)posture, attitude
- the spatial property of a place where or way in which something is situated; "the position of the hands on the clock"; "he specified the spatial relations of every piece of furniture on the stage" (同)spatial relation
- (in team sports) the role assigned to an individual player; "what position does he play?"
- the act of positing; an assumption taken as a postulate or axiom
- the particular portion of space occupied by something; "he put the lamp back in its place" (同)place
- a rationalized mental attitude (同)stance, posture
- a way of regarding situations or topics etc.; "consider what follows from the positivist view" (同)view, perspective
- the appropriate or customary location; "the cars were in position"
PrepTutorEJDIC
- 〈C〉『位置;場所』;所在地 / 〈U〉所定の位置,適所 / 〈C〉『姿勢』,構え / 〈U〉有利な地位(立場) / 〈C〉《通例単数形で》(周囲の状況と関連する)『立場,境遇』;形勢,情況 / 〈C〉見解,態度 / 〈C〉(…としての)勤め口,職《+『as(of)+名』》 / 〈C〉(…の中の)地位《+『in+名』》 / 〈U〉(特に高い)社会的地位 / 《副詞[句]を伴って》…‘を'適当な(特定の)場所に置く
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2016/02/04 00:51:30」(JST)
[Wiki en表示]
Old depiction of the Trendelenburg position.
In the Trendelenburg position, the body is laid flat on the back (supine position) with the feet higher than the head by 15-30 degrees, in contrast to the reverse Trendelenburg position, where the body is tilted in the opposite direction. Trendelenburg is a standard position used in abdominal and gynecological surgery. It allows better access to the pelvic organs as gravity pulls the intestines away from the pelvis. It was named after the German surgeon Friedrich Trendelenburg.[1]
In the past, Trendelenburg position was used for patients in hypovolemic shock, with the thought that it would help maintain blood flow to the brain. This is no longer recommended because research shows it to be counterproductive.[2]
Trendelenburg position In Surgery.
Contents
- 1 Current uses
- 2 Obsolete uses
- 3 See also
- 4 References
- 5 External links
Current uses
- The Trendelenburg position along with the Valsalva maneuver, termed as modified-Valsalva maneuver, is used for the cardioversion of ventricular tachycardia[3]
- The Trendelenburg position is helpful in surgical reduction of an abdominal hernia.[4]
- The Trendelenburg position is also used when placing a central venous line.[5] The Trendelenburg position uses gravity to assist in the filling and distension of the upper central veins when placing a central line in the internal jugular or subclavian veins. It is also used in the placement of an external jugular peripheral line for the same reason. It plays no role in the placement of a femoral central venous line.
- The Trendelenburg position is also used in respiratory patients to create better perfusion.[6]
- The Trendelenburg position has occasionally been used to produce symptomatic relief from septum posticum cysts of the subarachnoid space in the spinal cord, but does not bring about any long term benefits.[7]
- The Trendelenburg position may be used for drainage images during endoscopic retrograde cholangiopancreatography. [8]
Obsolete uses
- People with hypotension (low blood pressure) have historically been placed in the Trendelenburg position in hopes of increasing their cerebral perfusion pressure (the blood pressure to the brain). A 2005 review found the "Literature on the position was scarce, lacked strength, and seemed to be guided by 'expert opinion.'"[9] A 2008 meta-analysis found adverse consequences to the use of the Trendelenburg position and recommended it be avoided.[10] However, the passive leg raising test is a useful clinical guide to fluid resuscitation and can be used for effective autotransfusion.[11]
- The Trendelenburg position used to be the standard first aid position for shock.[12]
- The Trendelenburg position was used for injured scuba divers.[13] Many experienced divers still believe this position is appropriate, but current scuba first aid professionals no longer advocate elevating the feet higher than the head. The Trendelenburg position in this case increases regurgitation and airway problems, causes the brain to swell, increases breathing difficulty, and has not been proven to be of any value.[14] "Supine is fine" is a good, general rule for victims of submersion injuries unless they have fluid in the airway or are breathing, in which case they should be positioned on the side.
See also
- Trendelenburg gait
- Trendelenburg's sign
- Fowler's position
- High Fowlers position
- Recovery position
- Semi-Fowlers position
References
- ^ Enersen, Ole Daniel. "Trendelenburg's position". Whonamedit.com. Retrieved 2009-03-04.
- ^ Kettaneh N (2010). "Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 4. Use of the trendelenburg position to improve haemodynamics during hypovolaemic shock". Emergency Medicine Journal 27 (11): 877–8. doi:10.1136/emj.2010.104893. PMID 20972235.
- ^ "Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial.". Lancet. doi:10.1016/S0140-6736(15)61485-4. PMID 26314489. Retrieved 21 January 2016.
- ^ Buchwald H (1998). "Three helpful techniques for facilitating abdominal procedures, in particular for surgery in the obese". American Journal of Surgery 175 (1): 63–4. doi:10.1016/S0002-9610(97)00233-X. PMID 9445243.
- ^ Central Venous Access Imaging at eMedicine
- ^ Powers SK, Stewart MK, Landry G (1988). "Ventilatory and gas exchange dynamics in response to head-down tilt with and without venous occlusion". Aviation, Space, and Environmental Medicine 59 (3): 239–45. PMID 3355478.
- ^ Teng P, Rudner N (1960). "Multiple arachnoid diverticula". Archives of Neurology 2: 348–56. doi:10.1001/archneur.1960.03840090112015. PMID 13837415.
- ^ Leung, Joseph. "Fundamentals of ERCP". In Cotton, Peter B. ERCP. GastroHep.
- ^ Bridges N, Jarquin-Valdivia AA (2005). "Use of the Trendelenburg position as the resuscitation position: to T or not to T?". American Journal of Critical Care 14 (5): 364–8. PMID 16120887.
- ^ Kettaneh, Nicolas (October 30, 2008). "Use of the Trendelenburg Position to Improve Hemodynamics During Hypovolemic Shock". BestBets.
- ^ Terai C, Anada H, Matsushima S, Kawakami M, Okada Y (1996). "Effects of Trendelenburg versus passive leg raising: autotransfusion in humans". Intensive Care Medicine 22 (6): 613–4. doi:10.1007/BF01708113. PMID 8814487.
- ^ Johnson S, Henderson SO (2004). "Myth: the Trendelenburg position improves circulation in cases of shock". CJEM 6 (1): 48–9. doi:10.1017/S1481803500008915. PMID 17433146.
- ^ Stonier, JC (1985). "A study in prechamber treatment of cerebral air embolism patients by a first provider at Santa Catalina Island". Undersea Biomedical Research (Undersea and Hyperbaric Medical Society) 12 (1 supplement). Retrieved 2009-03-19.
- ^ Dysbarism at eMedicine
External links
|
Wikimedia Commons has media related to Trendelenburg position. |
- Illustration of position in comparison to other positions
- Human Kinetics' Victim Positioning
- According to The Canadian Journal of Anesthesia
UpToDate Contents
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English Journal
- Cerebral herniation associated with central venous catheter insertion: Risk assessment.
- Ziai WC, Chandolu S, Geocadin RG.SourceDepartment of Neurology, Division of Neurosciences Critical Care, Anesthesia and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. Electronic address: weziai@jhmi.edu.
- Journal of critical care.J Crit Care.2013 Apr;28(2):189-95. doi: 10.1016/j.jcrc.2012.09.013. Epub 2012 Nov 14.
- PURPOSE: Central venous catheters (CVCs) are often necessary to treat acute brain-injured patients. Four cases of cerebral herniation immediately following central venous catheterization were the impetus for an investigation of clinical and radiologic parameters associated with this complication.MAT
- PMID 23159141
- The influence of hip abductor weakness on frontal plane motion of the trunk and pelvis in patients with cerebral palsy.
- Krautwurst BK, Wolf SI, Heitzmann DW, Gantz S, Braatz F, Dreher T.SourceHeidelberg University Clinics, Department for Orthopedics and Trauma Surgery, Schlierbacher Landstraße 200a, 66118 Heidelberg, Germany.
- Research in developmental disabilities.Res Dev Disabil.2013 Apr;34(4):1198-203. doi: 10.1016/j.ridd.2012.12.018. Epub 2013 Feb 6.
- Trendelenburg walking pattern is a common finding in various disorders, including cerebral palsy (CP), where it is seen in children and adults. Clinically, this deviation is viewed as a consequence of hip abductor weakness resulting in pelvic obliquity. Trunk lean to the ipsilateral side is a common
- PMID 23396196
Japanese Journal
- 腹腔鏡下内肛門括約筋切除術後に下肢のAcute compartment syndromeをきたした進行下部直腸癌の1例
- 宗方 幸二,竹政 伊知朗,植村 守,原口 直紹,西村 潤一,畑 泰司,水島 恒和,山本 浩文,土岐 祐一郎,森 正樹
- 日本大腸肛門病学会雑誌 67(2), 97-102, 2014
- 手術に関連するAcute compartment syndrome(ACS)は稀であり,早期の診断と加療が重要である.腹腔鏡下内肛門括約筋切除術後に下肢のACSをきたした症例を経験したので報告する.症例は進行下部直腸癌の40歳代男性.術前検査で側方リンパ節転移が疑われ,術前化学療法後に腹腔鏡下内肛門括約筋切除術および治療的両側側方リンパ節郭清術を施行した.体位は開脚頭低位を基本とし,会陰操作と側方 …
- NAID 130003394576
- Cardiovascular and respiratory effects of the degree of head-down angle during robot-assisted laparoscopic radical prostatectomy
- Kadono Yoshifumi,Yaegashi Hiroshi,Machioka Kazuaki,Ueno Satoru,Miwa Sotaro,Maeda Yuji,Miyagi Tohru,Mizokami Atsushi,Fujii Yuka,Tsubokawa Tsunehisa,Yamamoto Ken,Namiki Mikio
- International Journal of Medical Robotics and Computer Assisted Surgery 9(1), 17-22, 2013-03
- … Background: Robot-assisted laparoscopic radical prostatectomy (RALP) requires a steep Trendelenburg position and CO2 pneumoperitoneum for several hours to secure the surgical visual field. … The present study was performed to investigate the influence of each angle of Trendelenburg position during RALP on cardiovascular and respiratory homeostasis. …
- NAID 120005253905
- Three Cases of Laparoscopic Surgery after the Fontan Procedure
- 菅本 健司,小川 潔,星野 健司,菱谷 隆,斉藤 千徳,藤本 義隆,野村 耕司,篠原 玄,山本 祐介,保科 俊之,水戸野 裕之,濱屋 和泉,内田 広夫
- Pediatric Cardiology and Cardiac Surgery 29(1), 43-48, 2013
- … In addition, mechanical ventilation and the Trendelenburg position during laparoscopic surgery may deteriorate passive pulmonary circulation due to increased intra-thoracic pressure. …
- NAID 130003380011
Related Links
- The Trendelenburg position is credited to german surgeon Friedrich Trendelenburg, who created the position to improve surgical exposure of the pelvic organs during operations.The Trendelenburg position involves placing the patients ...
- position /po·si·tion/ (pah-zish´un) 1. a bodily posture or attitude. 2. the relationship of a given point on the presenting part of the fetus to a designated point of the maternal pelvis. anatomical position that of the human body standing ...
- Trendelenburg Position. 92 likes · 5 talking about this. Dienamik, Lori Condarcure, Thaddeus Taraskiewicz, Mari 'Mickey' Marco ... A fusion of a 70's/80's rock inspired drummer, a metal/rock inspired guitarist, jazz/punk bassist, and ...
★リンクテーブル★
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- 英
- Trendelenburg position
- 同
- トレンデレンブルグ体位、骨盤高位
- 関
- 体位
[show details]
- 循環血流量が減少している場合、トレンデレンブルグ位でも静脈還流量・心拍出量は増加しない。循環血液量が過剰なときには効果がある。(ICU.191)
参考
- http://www.realself.com/files/352021-195712.png
- http://best4med.com/view_video.php?viewkey=f50967c64dac2d639a57&page=1&viewtype=basic&category=
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切石位トレンデレンブルグ体位
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- 関
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