To assess whether the passive leg raising test can help in predicting fluid responsiveness.
Nonsystematic review of the literature.
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.
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.
KeywordsFluid responsiveness Passive leg raising Volume expansion Cardiac preload
- 18.Michard F, Boussat S, Chemla D, Anguel N, Mercat A, Lecarpentier Y, Richard C, Pinsky MR, Teboul JL (2000) Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. Am J Respir Crit Care Med 162:134–138PubMedGoogle Scholar
- 27.Monnet X, Richard C, Teboul JL (2007) Passive leg raising. In: Vincent JL (ed) Yearbook of intensive care and emergency medicine. Springer, Berlin Heidelberg New York, pp 542–548Google Scholar
- 29.Zogheib E, Defouilloy C, Mahjoub Y, Cherradi N, Moubarak M, Beloucif S, Dupont H (2007) Modification of hemodynamic effect after passive leg raising test by the use of elastic compression stocking (abstract). Intensive Care Med 33:S72Google Scholar
- 32.Ridel C, Lamia B, Monnet X, Richard C, Teboul JL (2006) Passive leg raising and fluid responsiveness during spontaneous breathing: pulse contour evaluation. Intensive Care Med 32:S81Google Scholar