Carotid and femoral Doppler do not allow the assessment of passive leg raising effects

Annals of Intensive Care
Valentina GirottoXavier Monnet

Abstract

The hemodynamic effects of the passive leg raising (PLR) test must be assessed through a direct measurement of cardiac index (CI). We tested whether changes in Doppler common carotid blood flow (CBF) and common femoral artery blood flow (FBF) could detect a positive PLR test (increase in CI ≥ 10%). We also tested whether CBF and FBF changes could track simultaneous changes in CI during PLR and volume expansion. In 51 cases, we measured CI (PiCCO2), CBF and FBF before and during a PLR test (one performed for CBF and another for FBF measurements) and before and after volume expansion, which was performed if PLR was positive. Due to poor echogenicity or insufficient Doppler signal quality, CBF could be measured in 39 cases and FBF in only 14 cases. A positive PLR response could not be detected by changes in CBF, FBF, carotid nor by femoral peak systolic velocities (areas under the receiver operating characteristic curves: 0.58 ± 0.10, 0.57 ± 0.16, 0.56 ± 0.09 and 0.64 ± 10, respectively, all not different from 0.50). The correlations between simultaneous changes in CI and CBF and in CI and FBF during PLR and volume expansion were not significant (p = 0.41 and p = 0.27, respectively). Doppler measurements of CBF and of FBF, as well...Continue Reading

References

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Nov 20, 2016·Annals of Intensive Care·Xavier MonnetJean-Louis Teboul
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Citations

Apr 22, 2020·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Lance BeierJ Matthew Fields
Apr 26, 2020·Current Opinion in Critical Care·Rui ShiJean-Louis Teboul
Jun 11, 2020·Critical Care Medicine·Olfa HamzaouiJean-Louis Teboul
Feb 2, 2020·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·David McGregorTim Harris
Feb 19, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Jon-Émile S Kenny
Feb 20, 2021·Open Access Emergency Medicine : OAEM·German Devia Jaramillo, Salvador Menendez Ramirez
Jul 23, 2020·Critical Care Medicine·Olfa HamzaouiJean-Louis Teboul
Apr 2, 2021·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Ganesh ChowhanAnjan Trikha

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Software Mentioned

MedCalc
VTI
PiCCO Win
HEM
TAMEAN

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