Intensive Care Medicine

, Volume 34, Issue 4, pp 659–663

Passive leg raising

Clinical Commentary

Abstract

Objective

To assess whether the passive leg raising test can help in predicting fluid responsiveness.

Design

Nonsystematic review of the literature.

Results

Passive leg raising has been used as an endogenous fluid challenge and tested for predicting the hemodynamic response to fluid in patients with acute circulatory failure. This is now easy to perform at the bedside using methods that allow a real time measurement of systolic blood flow. A passive leg raising induced increase in descending aortic blood flow of at least 10% or in echocardiographic subaortic flow of at least 12% has been shown to predict fluid responsiveness. Importantly, this prediction remains very valuable in patients with cardiac arrhythmias or spontaneous breathing activity.

Conclusions

Passive leg raising allows reliable prediction of fluid responsiveness even in patients with spontaneous breathing activity or arrhythmias. This test may come to be used increasingly at the bedside since it is easy to perform and effective, provided that its effects are assessed by a real-time measurement of cardiac output.

Keywords

Fluid responsiveness Passive leg raising Volume expansion Cardiac preload 

Supplementary material

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Electronic Supplementary Material (MOV 8,0M)
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Electronic Supplementary Material (AVI 8,7M)

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  1. 1.Service de réanimation médicaleHôpital de Bicêtre, AP-HPLe Kremlin-BicêtreFrance
  2. 2.Equipe d’accueil EA 4046, Faculté de Médecine Paris-SudUniversité Paris-SudLe Kremlin-BicêtreFrance

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