Passive leg raising test in volume resuscitation

doi:10.3877/cma.j.jssn.2096-1537.2016.01.014

Abstract

Abstract:

Passive leg raising(PLR) is a new method for predicting volume responsiveness. Growing evidence suggests that overzealous fluid administration is deleterious in critically ill patients, particularly in those with sepsis after initial resuscitation in ICUs. Detecting preload respondents or preload non-respondents is an important issue in critically ill patients in order to differentiate patients who can be benefited from volume expansion and those who cannot, thus avoiding in the latter volume overload. It is demonstrated that statistical indicators of preload cannot predict fluid responsiveness in contrast to dynamic tests. The analysis of respiratory variation of stroke volume and surrogates such as PPV has shown abundant evidence that cannot be used in cases of spontaneous breathing activity, cardiac arrhythmia, low tidal volume or low lung compliance. PLR can solve the problem in predicting fluid responsiveness when PPV cannot be interpreted appropriately. Volume responsiveness is predicted by the changes in stroke volume or its surrogates induced by PLR. PLR, taken as a reversible"self-volume challenge", is a functional hemodynamic parameter. It can be used to predict volume responsiveness accurately. PLR has the advantages of simple operation, high safety, not disturbed by spontaneous breathing or arrhythmia and not restricted by monitoring equipments. It should be used to guide fluid therapy in clinical practice.

Key words: Passive leg raising, Volume resuscitation, Hemodynamic

Jiangquan Fu, Difen Wang. Passive leg raising test in volume resuscitation[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2016, 02(01): 63-67.

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