title: Passive Leg-Raising and Prediction of Fluid Responsiveness: Systematic Review.
abstract: Fluid boluses are often administered with the aim of improving tissue hypoperfusion in shock. However, only approximately 50% of patients respond to fluid administration with a clinically significant increase in stroke volume. Fluid overload can exacerbate pulmonary edema, precipitate respiratory failure, and prolong mechanical ventilation. Therefore, it is important to predict which hemodynamically unstable patients will increase their stroke volume in response to fluid administration, thereby avoiding deleterious effects. Passive leg-raising (lowering the head and upper torso from a 45° angle to lying supine [flat] while simultaneously raising the legs to a 45° angle) is a transient, reversible autotransfusion that simulates a fluid bolus and is performed to predict a response to fluid administration. The article reviews the accuracy, physiological effects, and factors affecting the response to passive-leg raising to predict fluid responsiveness in critically ill patients.
authors.affiliation: Joya D. Pickett completed her doctoral degree at the University of Washington, School of Nursing, and practices as a critical care clinical nurse specialist at Swedish Medical Center in Seattle, Washington. joyap@u.washington.edu.|Elizabeth Bridges is an associate professor at the University of Washington School of Nursing and the clinical nurse researcher at the University of Washington Medical Center, Seattle, Washington. joyap@u.washington.edu.|Patricia (Trish) A. Kritek is the medical director of Critical Care at the University of Washington Medical Center. joyap@u.washington.edu.|JoAnne D. Whitney is a professor of nursing at the University of Washington, School of Nursing, and a nurse scientist at Harborview Medical Center, Seattle, Washington. joyap@u.washington.edu.
authors.forename: Joya D
authors.initials: JD
authors.lastname: Pickett
authors.affiliation: Joya D. Pickett completed her doctoral degree at the University of Washington, School of Nursing, and practices as a critical care clinical nurse specialist at Swedish Medical Center in Seattle, Washington.|Elizabeth Bridges is an associate professor at the University of Washington School of Nursing and the clinical nurse researcher at the University of Washington Medical Center, Seattle, Washington.|Patricia (Trish) A. Kritek is the medical director of Critical Care at the University of Washington Medical Center.|JoAnne D. Whitney is a professor of nursing at the University of Washington, School of Nursing, and a nurse scientist at Harborview Medical Center, Seattle, Washington.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bridges
authors.affiliation: Joya D. Pickett completed her doctoral degree at the University of Washington, School of Nursing, and practices as a critical care clinical nurse specialist at Swedish Medical Center in Seattle, Washington.|Elizabeth Bridges is an associate professor at the University of Washington School of Nursing and the clinical nurse researcher at the University of Washington Medical Center, Seattle, Washington.|Patricia (Trish) A. Kritek is the medical director of Critical Care at the University of Washington Medical Center.|JoAnne D. Whitney is a professor of nursing at the University of Washington, School of Nursing, and a nurse scientist at Harborview Medical Center, Seattle, Washington.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Kritek
authors.affiliation: Joya D. Pickett completed her doctoral degree at the University of Washington, School of Nursing, and practices as a critical care clinical nurse specialist at Swedish Medical Center in Seattle, Washington.|Elizabeth Bridges is an associate professor at the University of Washington School of Nursing and the clinical nurse researcher at the University of Washington Medical Center, Seattle, Washington.|Patricia (Trish) A. Kritek is the medical director of Critical Care at the University of Washington Medical Center.|JoAnne D. Whitney is a professor of nursing at the University of Washington, School of Nursing, and a nurse scientist at Harborview Medical Center, Seattle, Washington.
authors.forename: JoAnne D
authors.initials: JD
authors.lastname: Whitney
mesh_terms: D016638:Critical Illness / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D020896:Hypovolemia / Q000628:therapy*; D007866:Leg / Q000503:physiopathology*; D008297:Male; D009068:Movement / Q000502:physiology*; D011237:Predictive Value of Tests; D013318:Stroke Volume / Q000502:physiology*