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


METHODS
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.
Monnet
Xavier
X
Service de réanimation médicale, Hôpital de Bicêtre, AP-HP, 78 rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France. xavier.monnet@bct.aphp.fr
Teboul
Jean-Louis
JL
D002302:Cardiac Output; D003935:Diagnostic Techniques, Cardiovascular; D005440:Fluid Therapy; D006439:Hemodynamics; D006801:Humans; D007866:Leg; D019095:Point-of-Care Systems; D011187:Posture; D012769:Shock / Q000175:diagnosis* / Q000628:therapy