Central venous pressure measurements improve the accuracy of leg raising-induced change in pulse pressure to predict fluid responsiveness.

Intensive Care Medicine
K LakhalT Boulain

Abstract

Passive leg raising (PLR) is a maneuver performed to test the cardiac Frank-Starling mechanism. We assessed the influence of PLR-induced changes in preload on the performance of PLR-induced change in pulse pressure (Delta(PLR)PP) and cardiac output (Delta(PLR)CO) for fluid responsiveness prediction. Sedated, nonarrhythmic patients with persistent shock were included in this prospective multicenter study. Cardiac output and pulse pressure were measured at baseline (patient supine), during PLR (lower limbs lifted to 45 degrees) and after 500-ml volume expansion. Patients were classified as responders or not. In the whole population (n = 102), the area under the receiver-operating characteristic curve (AUC) was 0.76 for Delta(PLR)PP and was higher for Delta(PLR)CO (0.89)(p < 0.05), but likelihood ratios were close to 1. In patients with a PLR-induced increase in central venous pressure (CVP) of at least 2 mmHg (n = 49), Delta(PLR)PP and Delta(PLR)CO disclosed higher AUCs than in the rest of the population (0.91 vs. 0.66 and 0.98 vs. 0.83; p < 0.05); positive/negative likelihood ratios were 9.3/0.14 (8% cutoff level) and 30/0.07 (7% cutoff level), respectively. A PLR-induced change in CVP > or =2 mmHg was required to allow clinical...Continue Reading

References

Feb 1, 1997·Chest·P SquaraJ L Teboul
Aug 29, 1998·Intensive Care Medicine·S Magder
Nov 30, 2000·Critical Care : the Official Journal of the Critical Care Forum·F Michard, J L Teboul
Jan 1, 1965·British Heart Journal·M THOMAS, J SHILLINGFORD
Feb 14, 2004·Annals of the Rheumatic Diseases·M C LodderJ C Roos
Mar 9, 2005·Acta Anaesthesiologica Scandinavica·M OstergaardP G Berthelsen
Mar 9, 2005·Intensive Care Medicine·Daniel De BackerJean-Louis Vincent
Apr 27, 2005·Lancet·David A Grimes, Kenneth F Schulz
Jun 2, 2005·Current Opinion in Critical Care·Sheldon Magder
Mar 17, 2006·Critical Care Medicine·Xavier MonnetJean-Louis Teboul
Mar 25, 2006·Critical Care Medicine·Jean-Louis Vincent, Max Harry Weil
May 5, 2006·Current Opinion in Critical Care·Sheldon Magder
May 23, 2006·The New England Journal of Medicine·UNKNOWN National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials NetworkAndrea L Harabin
Jun 10, 2006·Critical Care Medicine·Sheldon Magder
Sep 15, 2006·Critical Care : the Official Journal of the Critical Care Forum·A LafanechèreA Cariou
Nov 3, 2006·Critical Care Medicine·David OsmanJean-Louis Teboul
May 18, 2007·Intensive Care Medicine·Julien MaizelMichel Slama
Mar 21, 2008·Intensive Care Medicine·Vincent CailleAntoine Vieillard-Baron
Sep 17, 2008·Intensive Care Medicine·Julien JabotXavier Monnet
Apr 9, 2009·Anesthesiology·Daniel De BackerJean-Louis Vincent
Jul 10, 2009·Critical Care : the Official Journal of the Critical Care Forum·Steven W ThielWarren Isakow

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Citations

May 25, 2010·Intensive Care Medicine·Xavier Monnet, Jean-Louis Teboul
Jul 29, 2010·Intensive Care Medicine·Brahim BenomarPierre Squara
Dec 12, 2012·Intensive Care Medicine·Clément BrunMarc Leone
Aug 25, 2012·Critical Care Research and Practice·Adil Shujaat, Abubakr A Bajwa
Sep 13, 2011·Annals of Intensive Care·Paul E MarikJean-Louis Teboul
Mar 10, 2011·Critical Care : the Official Journal of the Critical Care Forum·Karim LakhalThierry Boulain
Sep 20, 2011·Critical Care : the Official Journal of the Critical Care Forum·Pierre-Grégoire GuinotHervé Dupont
Sep 29, 2011·Journal of Clinical Monitoring and Computing·Geoffray KellerJean-Jacques Lehot
Jan 31, 2016·Intensive Care Medicine·Xavier MonnetJean-Louis Teboul
Jun 12, 2014·Journal of Cardiothoracic and Vascular Anesthesia·Thomas G V CherpanathBart F Geerts
Apr 21, 2012·Annales Françaises D'anesthèsie Et De Rèanimation·B Tavernier, A Ouattara
Apr 3, 2012·Annales Françaises D'anesthèsie Et De Rèanimation·K LakhalT Boulain
Feb 7, 2015·Critical Care : the Official Journal of the Critical Care Forum·Matthieu BiaisUNKNOWN AzuRea Group
Nov 26, 2015·Critical Care : the Official Journal of the Critical Care Forum·Laurent GuérinXavier Monnet
Dec 24, 2011·Cardiology Research and Practice·Sébastien PréauFabienne Saulnier
Jun 24, 2015·Current Opinion in Critical Care·Ogbonna C OgbuGreg S Martin
Feb 7, 2015·Critical Care : the Official Journal of the Critical Care Forum·Xavier Monnet, Jean-Louis Teboul
Apr 17, 2016·Anaesthesia Critical Care & Pain Medicine·Marc-Olivier FischerUNKNOWN French Hemodynamic Team
Jul 15, 2016·Chinese Medical Journal·Huai-Wu He, Da-Wei Liu
Jul 20, 2016·Critical Care Medicine·Karim LakhalThierry Boulain
Jul 20, 2016·Critical Care Medicine·Thomas Gerardus Varghese Cherpanath
Jan 8, 2016·Critical Care Medicine·Thomas G V CherpanathA B Johan Groeneveld
Aug 21, 2016·British Journal of Anaesthesia·K LakhalT Boulain
May 18, 2017·Anesthesia and Analgesia·Antonio MessinaPaolo Navalesi
Apr 4, 2017·Critical Care Nurse·Joya D PickettJoAnne D Whitney
Apr 22, 2011·Current Opinion in Critical Care·Maurizio CecconiAndrew Rhodes
Nov 3, 2020·Critical Care : the Official Journal of the Critical Care Forum·Antoine Vieillard-BaronGuillaume Geri
Apr 27, 2021·Current Opinion in Critical Care·Chaisith SivakornArjen M Dondorp

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