title: [Passive leg raising predicts volume responsiveness in patients with septic shock].
abstract: OBJECTIVE
  To evaluate the hemodynamic response to passive leg raising (PLR) indicates fluid responsiveness in patients with septic shock.
  
  
  METHODS
  Twenty patients with septic shock, considered for fluid challenge (FC), were enrolled in the study from June 2009 to May 2010. Hemodynamic changes were determined by pulse-contour derived cardiac index at baseline, before and after PLR, return to baseline for 10 min, before and after fluid challenge (250 ml saline for 10 min). An increase of SV after fluid challenge (FC-ΔSV) ≥ 10% were defined responders.
  
  
  RESULTS
  Twenty patients with septic shock were included in the study. PLR and fluid challenge were performed 46 instances, among which 15 instances were defined as response group. SV and pulse pressure induced by PLR (PLR-ΔSV and PLR-ΔPP) were increased significantly in response group [(76 ± 19) ml vs. (65 ± 18) ml, (73 ± 20) mmHg vs. (62 ± 20) mmHg (1 mmHg = 0.133 kPa), P < 0.05], while in nonresponse group there were no significant change. PLR-ΔSV and PLR-ΔPP were correlated with FC-ΔSV (r = 0.51, P = 0.001; r = 0.45, P = 0.006), central venous pressure (CVP) were unrelated with FC-ΔSV. Area under curve (AUC) for PLR-ΔSV, PLR-ΔPP and stroke volume variation (SVV) were 0.846, 0.791 and 0.708. PLR-ΔSV ≥ 12.5% predicted fluid responsiveness with sensitivity of 80% and specificity of 93.5%. PLR-ΔPP ≥ 9.5% predicted fluid responsiveness with sensitivity of 73.3% and specificity of 83.9%.
  
  
  CONCLUSIONS
  PLR-ΔSV and PLR-ΔPP can predict fluid responsiveness in patients with septic shock. PLR-ΔSV and PLR-ΔPP have a greater ability in predicting volume responsiveness than CVP and SVV.
authors.affiliation: Department of Critical Care Medicine, Zhongda Hospital, Southeast University, Nanjing 210009, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Liu
authors.forename: Yuan-Hua
authors.initials: YH
authors.lastname: Lu
authors.forename: Jian-Feng
authors.initials: JF
authors.lastname: Xie
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Qiu
authors.forename: Liang
authors.initials: L
authors.lastname: Dong
authors.forename: Cong-Shan
authors.initials: CS
authors.lastname: Yang
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.forename: Hai-Bo
authors.initials: HB
authors.lastname: Qiu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D011187:Posture; D012680:Sensitivity and Specificity; D012772:Shock, Septic / Q000503:physiopathology*