What Is Trendelenburg Position? Bed Position Trendelenburg (2023)

What Is Trendelenburg Position? Bed Position Trendelenburg (1)

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What Is The Trendelenburg Position? One feature of the SonderCare line of home hospital beds is the Tilt function. It allows users to take on what is known in the medical world as the Trendelenburg position. What is this position, and why do many of our clients need it?

Note: SonderCare is a healthcare equipment supplier; please ask your healthcare provider for any clinical or medical advice.

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All of our articles are written by a professional medical writer and edited for accuracy by a hospital bed expert. SonderCare is a Hospital Bed company with locations across the U.S. and Canada. We distribute, install and service our certified home hospital beds across North America. Our staff is made up of several hospital bed experts that have worked in the medical equipment industry for more than 20 years. Read more about our company here.

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What Is The Trendelenburg Position for Hospital Beds?

The Trendelenburg position places a person in a supine position (lying face up) on an incline between 15 and 30 degrees to get the legs higher than the head. A modified version of the technique only raises the legs.

(Video) What is Trendelenburg in a Hospital Bed

The healthcare provider or user should minimize the degree of the Trendelenburg position as much as possible; if possible, the patient should be repositioned into the supine or reverse Trendelenburg position at established intervals.

What Is The Anti-Trendelenburg Position?

The Anti-Trendelenburg position, also known as the Reverse-Trendelenburg position, involves placing the patient in the same position at an incline of between 15 and 30 degrees. In this case, though, the head is higher than the legs.

What Is The Trendelenburg Position Used For?

German surgeon Friedrich Trendelenburg invented the position; he used this method initially to improve the exposure of the pelvic organs during surgery. During World War I, doctors tried it for treating shock and hypotension, hoping it would increase blood perfusion to vital organs (this is now understood to be ineffective). In current surgical settings, the Trendelenburg position improves access to the pelvic organs by letting gravity move the patient’s abdominal organ towards the head.

In modern healthcare, doctors often turn to the Trendelenburg position for patients with respiratory issues. Raising the legs above the head may help improve the blood flow to the organs (called perfusion) in patients with respiratory illnesses. Healthcare professionals will also use it to increase respiratory function in overweight and obese patients by relieving pressure on the head.

Some users and healthcare providers believe resting in the Trendelenburg position for short periods will increase circulation and help the patient to relax. Users can also use the Anti-Trendelenburg position to improve circulation to the legs and feet.

How Does Trendelenburg Position Work For In-Home Hospital Beds?

Regardless of what they need it for, healthcare facilities and patients must have the correct equipment when using the Trendelenburg and Anti-Trendelenburg positions. Doctors and nurses use these features in medical facilities, but the beds can provide the same posture control and practicality at home, too.

Many doctors prescribe using one or both of these positions for their therapeutic benefits for congestive heart failure, edema, or other circulatory conditions. It’s believed that, in these healthcare cases, the patients must raise their legs above their heart for periods each day. If a physician prescribes this for an in-home patient, it’s good to have a hospital bed prepared to let them take on the position.

It could aid those who are dealing with issues related to restricted blood flow. A recent estimate suggests that 30 percent of seniors experience postural hypertension, causing a sudden and abrupt spike in blood pressure. It could lead to a person falling over due to this increase in blood pressure. The Trendelenburg position can allow patients to slowly raise and stabilize blood pressure before standing on their own.

Why Choose A Hospital Bed For In-Home Trendelenburg Positions?

By giving the user control over the bed’s Trendelenburg position, the tilting feature provides extra comfort and support for those who need a hospital bed. The Tilt feature may also be helpful for people who need their beds to sit up or raise their legs while in bed. Individuals with restricted mobility use the Trendelenburg position day-in-day-out to allow themselves to be comfortable. The Reverse-Trendelenburg position also helps patients with limited mobility sit right up in bed.

An electric hospital bed from SonderCare can also eliminate the need for manual tilting, which requires physical strength and can be very uncomfortable for patients and caregivers alike.

Frequently Asked Questions About Hospital Bed Positions

Lower abdominal operations such as colorectal, gynaecological, and gastrointestinal procedures, as well as central venous catheter implantation, are commonly performed in the Trendelenburg position. In a home setting it can be used to take pressure of critical areas and stimulate bloodflow.

(Video) Trendelenburg position

A supine posture with the patient tilted at a 45-degree inclination, such that the pelvis is higher than the head, used both during pelvic surgery or for shock. Also, some practitioners recommend it for therapeutic benefits.

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Henderson’s Maneuver is a similar technique used in emergency medicine and anesthesia to assist with the management of a patient’s airway and cardiac output. The maneuver involves placing the patient in a left lateral decubitus position, with the left arm extended above the head. This position is believed to improve venous return and pulmonary function, potentially enhancing resuscitation efforts. While the Henderson Maneuver has been widely used in the past, its effectiveness has been the subject of debate and further research is needed to determine its true utility in clinical practice. It is important for healthcare providers to carefully assess each patient’s individual needs and use a combination of evidence-based interventions to provide the best possible care.

This is used for a variety of purposes, including the treatment of pulmonary embolism. When the trendelenburg position is used, gravity pulls blood from the lower half of the body towards the head and chest, which can help to improve circulation and oxygenation. The trendelenburg position is also sometimes used as a position to improve surgical access, particularly during laparoscopic procedures. In these cases, shoulder braces may be used to help support the patient and prevent brachial plexus injury. A modified trendelenburg position, known as the steep trendelenburg, may also be used in certain situations. This position is used to increase venous return and is often used in conjunction with other treatments. It is important for healthcare providers to carefully consider the risks and benefits of the trendelenburg position before using it as a treatment option.

This position was first described by Friedrich Trendelenburg, a German surgeon, in 1844 and has been used for a variety of purposes over the years. One common use of the trendelenburg position is as a treatment for shock, particularly hypovolaemic shock. When the patient is in the trendelenburg position, gravity pulls the intra-abdominal organs towards the feet, which can help to improve circulation and oxygenation. The trendelenburg position may also be used in conjunction with passive leg raising, a technique in which the legs are elevated above the head. This position is thought to increase venous return and improve hemodynamics. While the trendelenburg position has been widely used, some studies have questioned its effectiveness and have not been able to support its use in all cases. The position is also used for laparoscopic surgery, as it can help to increase surgical access by pulling the intra-abdominal organs away from the operative site.

Patients are placed in a Trendelenburg position when their feet are higher than their heads, which is a medical position. Original use of this position was for treating hypotension; its effect may increase systolic blood pressure by improving venous return. By using a special bed or table, a patient can be placed in the trendelenburg position by elevating their feet. A shoulder brace may be used to maintain the patient’s position and prevent injury. During head and neck surgeries, the trendelenburg position also improves surgical access. This position can increase intracranial pressure and enable better exposure of the surgical site in these cases. In patients who are not intubated, the trendelenburg position should be used with caution due to its increased risk of air embolism. The trendelenburg position may be useful for treating low cardiac output, although its effectiveness in this regard is still debated, according to some studies.

An early proponent was Walter Cannon in the early 20th century, who believed that it could improve organ perfusion and increase blood pressure. However, later in his career, Cannon reversed his opinion on the trendelenburg position and stated that it was of limited value in the treatment of shock. Despite Cannon’s change of heart, the trendelenburg position remains in use today, although its effectiveness is still the subject of debate. One common use of the trendelenburg position is to improve surgical exposure of the pelvic organs. When the patient is in the trendelenburg position, gravity pulls the pelvic organs towards the feet, which can allow surgeons to better access and visualise the area. Some studies have found that the trendelenburg position can also help to visualise the inferior trabecular meshwork during ocular surgery. However, the risk of air embolism and other complications may deter its widespread use in clinical practice.

This is still a common way to increase venous return, increase cardiac output, and improve organ perfusion. The position has been used in a variety of clinical settings, including laparoscopic surgeries such as gallbladder removal. However, the effectiveness of the trendelenburg position has been the subject of debate over the years. In the 1920s, American physiologist Walter Cannon reversed his opinion on the position, stating that it was of limited value in the treatment of shock. Despite Cannon’s change of heart, the trendelenburg position remains in use today, although it is not always used as a primary treatment option.

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What is the Trendelenburg position used for? ›

Currently, the Trendelenburg position is often used in lower abdominal surgeries, including colorectal, gynecological, and genitourinary procedures. In this position, gravity pulls the intra-abdominal organs away from the pelvis, allowing for better surgical access to the pelvic organs.

What is the Trendelenburg feature on a hospital bed? ›

The Trendelenburg position is a feature integrated into most profiling and adjustable beds. The position places the person's head down and elevates the feet, so their whole body is sloping down with the feet higher than the rest of the body.

What is reverse Trendelenburg position in bed? ›

The Reverse Trendelenburg position is a position in which patients' hip and knee are not flexed but the head and chest are elevated at 30° than the abdomen and legs. The semi-recumbent position is an upright positioning of the head and torso at an angle of 45° while legs are lying on the bed.

When should a patient be placed in the Trendelenburg position? ›

Patients may be placed in the Trendelenburg position for surgical procedures involving the abdomen or when needing improved access to the pelvic organs.

How long can you keep a patient in Trendelenburg? ›

The risks associated with the Trendelen-burg position increase the steeper patients are angled and the longer they remain in the position. If a procedure is taking longer than three hours, consider flattening the patient out for a few minutes to give their body a break from the physical stressors of the position.

Does Trendelenburg help blood pressure? ›

However, researchers found that the use of Trendelenburg does not improve blood pressure and shock and instead, could have detrimental effects on specific patient populations.

Which hip is weak in Trendelenburg gait? ›

The weakness of the involved side causes a contralateral pelvic hip drop during swing phase. This contralateral hip drop might cause the quadratus lumborum, on the stance leg, to bring the pelvis back in neutral. [6] Posterior Lurch Gait.

What are the types of Trendelenburg position? ›

In the Trendelenburg position, the body is lain supine, or flat on the back on a 15–30 degree incline with the feet elevated above the head. The reverse Trendelenburg position, similarly, places the body supine on an incline but with the head now being elevated.

Why is it called Trendelenburg position? ›

The creation of Trendelenburg Position is credited to Friedrich Trendelenburg, a 19th century German surgeon. Originally, surgeons used the technique to improve the exposure and visibility of the pelvic organs. During World War I, Walter Cannon, an American physiologist, was a proponent of TP as a treatment for shock.

Why would you put a patient in reverse Trendelenburg? ›

[8] Reverse trendelenburg position is also used for neck and head surgery and gynecological procedures because it reduces the flow of blood to those areas. The reverse trendelenburg position is also used to improve surgical exposure of the prostate and minimally invasive upper abdominal procedures.

Does Trendelenburg position increase heart rate? ›

CVP increased significantly during Trendelenburg, while heart rate remained unchanged (Table 3).

What does Trendelenburg mean? ›

A trendelenburg gait is an abnormal gait resulting from a defective hip abductor mechanism. The primary musculature involved is the gluteal musculature, including the gluteus medius and gluteus minimus muscles. The weakness of these muscles causes drooping of the pelvis to the contralateral side while walking.

How do you put a bed in Trendelenburg? ›

What Is The Trendelenburg Position for Hospital Beds? The Trendelenburg position places a person in a supine position (lying face up) on an incline between 15 and 30 degrees to get the legs higher than the head. A modified version of the technique only raises the legs.

What are the complications of Trendelenburg position? ›

Table 1
Complications of Trendelenburg positionNumber (%)
Airway and/or facial edema36 (40%)
Brachial plexus injury15 (17%)
Corneal abrasion12 (13%)
Patient sliding off table8 (9%)
9 more rows
Aug 21, 2018

Does Trendelenburg decrease cardiac output? ›

surgery patients from the Trendelenburg position back to the horizontal position caused a significant decrease in cardiac output (P < 0.05), a non-significant decrease in MAP and a non-significant increase in heart rate (Table 2).

What position should a patient be in with hypotension? ›

One intervention commonly used to manage severe hypotension is Trendelenburg positioning, defined as a position in which the head is low and the body and legs are on an inclined or raised plane.

What position should a patient with low blood pressure be in? ›

Gently move from lying flat or squatting to a standing position. Don't sit with legs crossed. If symptoms of low blood pressure begin while standing, cross the thighs like a pair of scissors and squeeze.

Does lowering head of bed lower BP? ›

Raising the head of the bed decreases the amount of blood returning to the heart due to the effects of gravity. In this case, the decreased blood return to the heart may decrease blood pressure.
ConditionSupine Hypertension , Autonomic Failure
Last Modified on4 October 2022
3 more rows

What position raises blood pressure? ›

Posture affects blood pressure, with a general tendency for it to increase from the lying to the sitting or standing position.

Can Trendelenburg gait be fixed? ›

What's the outlook? Trendelenburg gait can be disruptive, but it's often treatable with special shoes or exercises designed to strengthen your hip abductor muscles. If an underlying condition, such as osteoarthritis or muscular dystrophy, is causing this gait, your doctor will help you develop a treatment plan.

What are the symptoms of hip drop? ›

Among the most common things we see in runners who have knee, hip, low back, and foot pain is known as hip drop. Hip drop is seen when someone is standing on one leg, and their pelvis tilts downwards towards the leg that is held in the air.

How do you fix hip drop? ›

Four Simple Exercises to Correct Your Hip Drop
  1. Hip Hitches – 3 sets of 15 each side.
  2. Isometric Glute Med Hold – 3 sets of 30 second holds each side.
  3. Resistance Band Crab Walk – 3 sets of 30 seconds each direction.
  4. Glute Med & Psoas Drill – 3 sets of 10 each side.

Which side is Trendelenburg? ›

Because the pelvis cannot be maintained in a level plane by the lesioned abductors, the patient falls towards the good side and simultaneously leans the torso towards the lesioned side in an attempt to maintain balance. This type of gait is known as the Trendelenburg gait.

What laying position lowers heart rate? ›

This is because the heart is on the left side of the chest and when lying on the left side the heart is closer to the chest wall. This physical closeness makes skipped and therefore skipped beats may be easier to feel. If you notice heart palpitation when lying down, try lying on your right side to see if this helps.

What position lowers your heart rate? ›

Participants that performed the laying down position showed the most significant decreases in heart rate.

What is the Trendelenburg test used to assess for? ›

Trendelenburg test investigates stability of the hip and particularly the ability of the hip abductors (gluteus medius and gluteus minimus) to stabilize the pelvis on the femur.

What is the best position for hypotension? ›

The Trendelenburg position (TP) is defined as “a position in which the head is low and the body and legs are on an inclined or raised plane” [2] and is traditionally being used to manage hypotension and hypovolemic shock. The intervention is named after a German surgeon, Dr.

Does reverse Trendelenburg lower blood pressure? ›

Conclusions: Reverse Trendelenburg position decreased central venous pressure without significantly decreasing the systolic blood pressure, suggesting that it is possible to perform hepatectomy with reverse Trendelenburg position more safely than with inferior vena cava clamping.

What are the cardiovascular changes in Trendelenburg position? ›

Anesthesia and the Trendelenburg position increased the CVP, PCWP and pulmonary arterial pressures and decreased cardiac output. Pneumoperitoneum increased these pressures further mostly in the beginning of the laparoscopy, and cardiac output decreased towards the end of the laparoscopy.

How does Trendelenburg affect cardiac output? ›

surgery patients from the Trendelenburg position back to the horizontal position caused a significant decrease in cardiac output (P < 0.05), a non-significant decrease in MAP and a non-significant increase in heart rate (Table 2).


1. Trulife Elite Trendelenburg Positioning System
(LLC PortexLand)
3. Patient Positioning in Steep Trendelenburg: TrenGuard™ Restraint [Demonstration]
(STERIS Healthcare United States)
4. Positions that are used for patients
(SD Nursing Academy)
5. Patient Positioning
(Surgical Tech Tips)
6. Trendelenburg & Reverse Trendelenburg Positions on ICU Bed
(Optium Healthcare Inc.)


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