<p style="text-align: justify;">The Trendelenburg position is a common intervention used to stabilize patients in hemodynamic shock. It has been assumed that the head-down tilt position would create a hydrostatic gradient to improve venous return and, therefore, increase the cardiac output. However, numerous studies have shown this maneuver to be ineffective for hemodynamic enhancement. This study analyzed the physiologic mechanisms responsible for the limited benefits of Trendelenburg positioning.</p>