Abstract:
OBJECTIVE:Rapid fluid loading is standard treatment for hypovolemia. Because volume expansion does not always improve hemodynamic status, predictive parameters of fluid responsiveness are needed. Passive leg raising is a reversible maneuver that mimics rapid volume expansion. Passive leg raising-induced changes in stroke volume and its surrogates are reliable predictive indices of volume expansion responsiveness for mechanically ventilated patients. We hypothesized that the hemodynamic response to passive leg raising indicates fluid responsiveness in nonintubated patients without mechanical ventilation. DESIGN:Prospective study. SETTING:Intensive care unit of a general hospital. PATIENTS:We investigated consecutive nonintubated patients, without mechanical ventilation, considered for volume expansion. INTERVENTIONS:We assessed hemodynamic status at baseline, after passive leg raising, and after volume expansion (500 mL 6% hydroxyethyl starch infusion over 30 mins). MEASUREMENTS AND MAIN RESULTS:We measured stroke volume using transthoracic echocardiography, radial pulse pressure using an arterial catheter, and peak velocity of femoral artery flow using continuous Doppler. We calculated changes in stroke volume, pulse pressure, and velocity of femoral artery flow induced by passive leg raising (respectively, Deltastroke volume, Deltapulse pressure, and Deltavelocity of femoral artery flow). Among 34 patients included in this study, 14 had a stroke volume increase of >or=15% after volume expansion (responders). All patients included in the study had severe sepsis (n = 28; 82%) or acute pancreatitis (n = 6; 18%). The Deltastroke volume >or=10% predicted fluid responsiveness with sensitivity of 86% and specificity of 90%. The Deltapulse pressure >or=9% predicted fluid responsiveness with sensitivity of 79% and specificity of 85%. The Deltavelocity of femoral artery flow >or=8% predicted fluid responsiveness with sensitivity of 86% and specificity of 80%. CONCLUSIONS:Changes in stroke volume, radial pulse pressure, and peak velocity of femoral artery flow induced by passive leg raising are accurate and interchangeable indices for predicting fluid responsiveness in nonintubated patients with severe sepsis or acute pancreatitis.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Préau S,Saulnier F,Dewavrin F,Durocher A,Chagnon JLdoi
10.1097/CCM.0b013e3181c8fe7asubject
Has Abstractpub_date
2010-03-01 00:00:00pages
819-25issue
3eissn
0090-3493issn
1530-0293journal_volume
38pub_type
杂志文章abstract:OBJECTIVES:Survivors of critical illness in early life are at risk of long-term-memory and attention impairments. However, their neurobiologic substrates remain largely unknown. DESIGN:A prospective follow-up study. SETTING:Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands. PATIENTS:Thirty-eight scho...
journal_title:Critical care medicine
pub_type: 杂志文章
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更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:To compare three devices that measure core body temperature at the bedside in ICU patients. DESIGN:Prospective, consecutive sample. SETTING:Voluntary community teaching hospital. PATIENTS:Fifteen patients, 78 +/- 6 (SD) yrs of age, admitted to the medical ICU over a 5-month period who had pulmonary artery ...
journal_title:Critical care medicine
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doi:10.1097/00003246-199106000-00015
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abstract:OBJECTIVES:Muscle weakness associated with critical illness can be due to the illness itself, immobilization associated with it, and/or to concomitant use of drugs that affect neuromuscular transmission. This study investigated the contribution of immobilization per se to the muscle dysfunction, as well as the associat...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199902000-00031
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更新日期:2007-11-01 00:00:00
abstract::In order to determine and analyze the complication rate of the insertion and maintenance of the balloon-tipped, flow-directed pulmonary artery catheter (PAC), the authors prospectively studied the use of 320 catheters in 219 critically ill patients. Mean patient age was 53 +/- 1 years, and 36% had a history of cardiov...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198104000-00006
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pub_type: 杂志文章
doi:10.1097/CCM.0b013e31819fc81a
更新日期:2009-05-01 00:00:00
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更新日期:2010-08-01 00:00:00
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更新日期:2003-03-01 00:00:00
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doi:10.1097/CCM.0B013E31816443CB
更新日期:2008-03-01 00:00:00
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doi:10.1097/01.CCM.0000243794.09377.96
更新日期:2006-11-01 00:00:00
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doi:10.1097/CCM.0000000000004425
更新日期:2020-09-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-01-01 00:00:00
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pub_type: 杂志文章
doi:
更新日期:1993-04-01 00:00:00
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doi:10.1097/CCM.0b013e31820ead5e
更新日期:2011-05-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003660
更新日期:2019-05-01 00:00:00
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更新日期:2015-09-01 00:00:00
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更新日期:2020-01-01 00:00:00
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更新日期:2018-09-01 00:00:00
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更新日期:1988-06-01 00:00:00
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pub_type: 杂志文章,meta分析
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更新日期:2008-05-01 00:00:00
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更新日期:2017-02-01 00:00:00
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更新日期:2005-01-01 00:00:00
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doi:10.1097/00003246-198106000-00013
更新日期:1981-06-01 00:00:00
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doi:10.1097/00003246-198904000-00004
更新日期:1989-04-01 00:00:00
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更新日期:2001-04-01 00:00:00
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更新日期:2000-09-01 00:00:00
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pub_type: 杂志文章,随机对照试验
doi:10.1097/01.CCM.0000285991.36698.E2
更新日期:2007-11-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2007-02-01 00:00:00