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Passive Leg Raising: Simple and Reliable Technique to Prevent Fluid Overload in Critically ill Patients

BACKGROUND: Dynamic measures, the response to stroke volume (SV) to fluid loading, have been used successfully to guide fluid management decisions in critically ill patients. However, application of dynamic measures is often inaccurate to predict fluid responsiveness in patients with arrhythmias, ve...

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Autor principal: Assadi, Farahnak
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5516436/
https://www.ncbi.nlm.nih.gov/pubmed/28757925
http://dx.doi.org/10.4103/ijpvm.IJPVM_11_17
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author Assadi, Farahnak
author_facet Assadi, Farahnak
author_sort Assadi, Farahnak
collection PubMed
description BACKGROUND: Dynamic measures, the response to stroke volume (SV) to fluid loading, have been used successfully to guide fluid management decisions in critically ill patients. However, application of dynamic measures is often inaccurate to predict fluid responsiveness in patients with arrhythmias, ventricular dysfunction or spontaneously breathing critically ill patients. Passive leg raising (PLR) is a simple bedside maneuver that may provide an accurate alternative to guide fluid resuscitation in hypovolemic critically ill patients. METHODS: Pertinent medical literature for fluid responsiveness in the critically ill patient published in English was searched over the past three decades, and then the search was extended as linked citations indicated. RESULTS: Thirty-three studies including observational studies, randomized control trials, systemic review, and meta-analysis studies evaluating fluid responsiveness in the critically ill patient met selection criteria. CONCLUSIONS: PLR coupled with real-time SV monitors is considered a simple, noninvasive, and accurate method to determine fluid responsiveness in critically ill patients with high sensitivity and specificity for a 10% increase in SV. The adverse effect of albumin on the mortality of head trauma patients and chloride-rich crystalloids on mortality and kidney function needs to be considered when choosing the type of fluid for resuscitation.
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spelling pubmed-55164362017-07-28 Passive Leg Raising: Simple and Reliable Technique to Prevent Fluid Overload in Critically ill Patients Assadi, Farahnak Int J Prev Med Original Article BACKGROUND: Dynamic measures, the response to stroke volume (SV) to fluid loading, have been used successfully to guide fluid management decisions in critically ill patients. However, application of dynamic measures is often inaccurate to predict fluid responsiveness in patients with arrhythmias, ventricular dysfunction or spontaneously breathing critically ill patients. Passive leg raising (PLR) is a simple bedside maneuver that may provide an accurate alternative to guide fluid resuscitation in hypovolemic critically ill patients. METHODS: Pertinent medical literature for fluid responsiveness in the critically ill patient published in English was searched over the past three decades, and then the search was extended as linked citations indicated. RESULTS: Thirty-three studies including observational studies, randomized control trials, systemic review, and meta-analysis studies evaluating fluid responsiveness in the critically ill patient met selection criteria. CONCLUSIONS: PLR coupled with real-time SV monitors is considered a simple, noninvasive, and accurate method to determine fluid responsiveness in critically ill patients with high sensitivity and specificity for a 10% increase in SV. The adverse effect of albumin on the mortality of head trauma patients and chloride-rich crystalloids on mortality and kidney function needs to be considered when choosing the type of fluid for resuscitation. Medknow Publications & Media Pvt Ltd 2017-07-04 /pmc/articles/PMC5516436/ /pubmed/28757925 http://dx.doi.org/10.4103/ijpvm.IJPVM_11_17 Text en Copyright: © 2017 International Journal of Preventive Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Assadi, Farahnak
Passive Leg Raising: Simple and Reliable Technique to Prevent Fluid Overload in Critically ill Patients
title Passive Leg Raising: Simple and Reliable Technique to Prevent Fluid Overload in Critically ill Patients
title_full Passive Leg Raising: Simple and Reliable Technique to Prevent Fluid Overload in Critically ill Patients
title_fullStr Passive Leg Raising: Simple and Reliable Technique to Prevent Fluid Overload in Critically ill Patients
title_full_unstemmed Passive Leg Raising: Simple and Reliable Technique to Prevent Fluid Overload in Critically ill Patients
title_short Passive Leg Raising: Simple and Reliable Technique to Prevent Fluid Overload in Critically ill Patients
title_sort passive leg raising: simple and reliable technique to prevent fluid overload in critically ill patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5516436/
https://www.ncbi.nlm.nih.gov/pubmed/28757925
http://dx.doi.org/10.4103/ijpvm.IJPVM_11_17
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