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Erschienen in:
01.04.2008 | Clinical Commentary
Passive leg raising
Erschienen in: Intensive Care Medicine | Ausgabe 4/2008
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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.