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Chirurgie 1. Juni 2012

The supine head-down tilt position that was named after the German surgeon Friedrich Trendelenburg

BACKGROUND: The supine head-down tilt position is routinely used in intensive care when inserting a central venous catheter to increase the lumen of the jugular or subclavian vein and to prevent air embolism during this procedure or to correct severe hypotension. The head-down tilt position is credited to the German surgeon Friedrich Trendelenburg (1844–1924), and is consequently named after him as the 'Trendelenburg position' or 'Trendelenburg posture'. METHODS: Analysis of relevant literature. RESULTS: Although a brilliant surgeon and excellent scientist, Friedrich Trendelenburg was not the first who utilized the posture that is named after him. The Dutch physician Abraham Cyprianus used a similar technique more than 170 years earlier in 1694. Furthermore, the terms 'head-down tilt posture' or 'semi-inverted posture' are more accurate to describe the posture in which we place our patients nowadays. This posture is not the same posture as the classic 'Trendelenburg position'. The posture in which we place patients during diagnostic, therapeutic and experimental interventions nowadays is identical to the 'semi-inverted posture' described by Cyprianus in 1694 and by Hewitt & Sheild in 1896 and not to Trendelenburg's posture. CONCLUSIONS: The posture in which we place patients during diagnostic, therapeutic and interventions and during clinical experimental research nowadays is identical to the 'semi-inverted posture' described by Hewitt & Sheild in 1896 and not to Trendelenburg's posture. We should name it in the most accurate way (semi-inverted posture).

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