Authors: Julien Jabot JeanLouis Teboul Christian Richard Xavier Monnet
Publish Date: 2008/09/16
Volume: 35, Issue: 1, Pages: 85-
Abstract
For predicting fluid responsiveness by passive leg raising PLR the lower limbs can be elevated at 45° either from the 45° semirecumbent position PLRSEMIREC or from the supine position PLRSUPINE PLRSUPINE could have a lower hemodynamic impact than PLRSEMIREC since it should not recruit the splanchnic venous reservoirPLRSEMIREC supine transfer and PLRSUPINE significantly increased the pulsecontour derived cardiac index PiCCOplus by 22 17–28 9 5–15 and 10 7–14 P 005 vs PLRSEMIREC for the latter two respectively These maneuvers significantly increased the right ventricular enddiastolic area echocardiography by 20 14–29 9 5–16 and 10 5–16 P 005 vs PLRSEMIREC for the latter two and the central venous pressure by 33 22–50 15 10–20 and 20 15–29 P 005 vs PLRSEMIREC for the latter two respectively Volume expansion significantly increased cardiac index by 27 21–38 and all patients were responders to volume expansion If an increase in cardiac index ≥ 10 is considered as a positive response to PLRSUPINE 15 43 patients would have been unduly predicted as nonresponders to fluid administration by PLRSUPINEThe authors are greatly indebted to Mrs Alexia Letierce from the Unité de Recherche Clinique of the Bicêtre Hospital for helpful statistical reviewing of the manuscript Prof JeanLouis Teboul and Dr Xavier Monnet are members of the Medical Advisory Board of the Pulsion Medical Systems Company The other authors have no financial interest to disclose
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