Increase in Central Venous Pressure During Passive Leg Raising Cannot Detect Preload Unresponsiveness.

Critical Care Medicine
Olfa HamzaouiJean-Louis Teboul

Abstract

By analogy with the classical central venous pressure rules to assess a fluid challenge, we hypothesized that an increase in central venous pressure greater than or equal to 5 cm H2O (i.e., 4 mm Hg) during passive leg raising can predict preload unresponsiveness diagnosed by the absence of increase in velocity-time integral of the left ventricular outflow tract greater than or equal to 10% during the test (negative passive leg raising test). Velocity-time integral was measured by transthoracic echocardiography. Central venous pressure and velocity-time integral were measured before and during passive leg raising. Critically ill patients for whom the physician decided to test preload responsiveness by passive leg raising were prospectively included. Fifty-seven set of measurements were performed in 50 patients. Preload unresponsiveness (negative passive leg raising test) was observed in 32 cases. The changes in central venous pressure during passive leg raising did not differ between positive passive leg raising cases (positive passive leg raising test) and negative passive leg raising test cases (3 ± 2 vs 3 ± 2 mm Hg, respectively) and thus did not predict preload unresponsiveness (area under the receiver-operating characterist...Continue Reading

Associated Clinical Trials

References

Jan 17, 2002·The New England Journal of Medicine·E RiversUNKNOWN Early Goal-Directed Therapy Collaborative Group
Jun 18, 2002·Chest·Frédéric Michard, Jean-Louis Teboul
Jun 10, 2006·Critical Care Medicine·Sheldon Magder
May 18, 2007·Intensive Care Medicine·Julien MaizelMichel Slama
Sep 17, 2008·Intensive Care Medicine·Julien JabotXavier Monnet
Feb 7, 2015·Critical Care : the Official Journal of the Critical Care Forum·Xavier Monnet, Jean-Louis Teboul
Jul 15, 2015·Intensive Care Medicine·Maurizio CecconiUNKNOWN ESICM Trial Group
Jan 31, 2016·Intensive Care Medicine·Xavier MonnetJean-Louis Teboul
Nov 20, 2016·Annals of Intensive Care·Xavier MonnetJean-Louis Teboul
Dec 7, 2016·Critical Care Medicine·Yasser SakrUNKNOWN Intensive Care Over Nations Investigators
Feb 24, 2018·Critical Care : the Official Journal of the Critical Care Forum·Daniel De Backer, Jean-Louis Vincent
May 31, 2018·Annals of Intensive Care·Valentina GirottoXavier Monnet
Jan 20, 2019·Critical Care : the Official Journal of the Critical Care Forum·Alexandra BeurtonXavier Monnet
Apr 12, 2019·Critical Care : the Official Journal of the Critical Care Forum·Mathieu JozwiakXavier Monnet

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Citations

Oct 17, 2020·Seminars in Respiratory and Critical Care Medicine·Daniel De Backer, Jean-Louis Vincent

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