We started the investigation which is here reported to determine the effects of the Trendelenburg position on the circulation and respiration, and to formulate rules for its safe employment. We had become convinced from cases observed by ourselves, and from communications from a large number of surgeons and anesthetists, that this posture may at times endanger the life of the patient during anesthesia. Our experiments, checked by clinical observations, have demonstrated, to our own satisfaction at least, that this conclusion is correct. But they have also shown that the Trendelenburg position is only one of several agencies which act in the same manner, namely, by increasing to a dangerous extent the flow of the blood to the heart. A study of cases of death during anesthesia under present-day conditions of surgery will show, we think, that more fatalities result from this cause than from its opposite—diminished supply brought
GATCH WD, GANN D, MANN FC. THE DANGER AND PREVENTION OF SEVERE CARDIAC STRAIN DURING ANESTHESIA. JAMA. 1913;60(17):1273–1278. doi:10.1001/jama.1913.04340170001001
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