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Intensive Care Medicine
Published in: Intensive Care Medicine 7/2008

01-07-2008 | Original

Hemodynamic effects of passive leg raising: an echocardiographic study in patients with shock

Authors: Vincent Caille, Julien Jabot, Guillaume Belliard, Cyril Charron, François Jardin, Antoine Vieillard-Baron

Published in: Intensive Care Medicine | Issue 7/2008

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Abstract

Objectives

To determine the effects of passive leg raising (PLR) on hemodynamics and on cardiac function according to the preload dependency defined by the superior vena cava collapsibility index (ΔSVC).

Results

Forty patients with shock, sedated and mechanically ventilated, were included. Transesophageal echocardiography was performed. At baseline (T1), two groups were defined according to ΔSVC. Eighteen patients presenting a ΔSVC > 36%, an indicator of preload dependency, formed group 1, whereas 22 patients (group 2) exhibited a ΔSVC < 30% (not preload-dependent). Measurements were then performed during PLR (T2), back to baseline (T3), and after volume expansion (T4) in group 1 only. At T1, ΔSVC was significantly higher in group 1 than in group 2, 50 ± 9% and 7 ± 6%, respectively. In group 1, we found a decrease in ΔSVC at T2 (24 ± 9%) and T4 (17 ± 7%), associated with increased systolic, diastolic and arterial pulse pressures. Cardiac index also increased, from 1.92 ± 0.74 (T1) to 2.35 ± 0.92 (T2) and 2.85 ± 1.2 l/min/m2 (T4) and left ventricular end-diastolic volume from 51 ± 41 to 61 ± 51 and 73 ± 51 ml/m2. None of these variations was found in group 2. No change in heart rate was observed.

Conclusion

Hemodynamic changes related to PLR were only induced by increased cardiac preload.
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Metadata
Title
Hemodynamic effects of passive leg raising: an echocardiographic study in patients with shock
Authors
Vincent Caille
Julien Jabot
Guillaume Belliard
Cyril Charron
François Jardin
Antoine Vieillard-Baron
Publication date
01-07-2008
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 7/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-008-1067-y

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