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Annals of Intensive Care
Published in: Annals of Intensive Care 1/2018

Open Access 01-12-2018 | Research

Carotid and femoral Doppler do not allow the assessment of passive leg raising effects

Authors: Valentina Girotto, Jean-Louis Teboul, Alexandra Beurton, Laura Galarza, Thierry Guedj, Christian Richard, Xavier Monnet

Published in: Annals of Intensive Care | Issue 1/2018

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Abstract

Background

The hemodynamic effects of the passive leg raising (PLR) test must be assessed through a direct measurement of cardiac index (CI). We tested whether changes in Doppler common carotid blood flow (CBF) and common femoral artery blood flow (FBF) could detect a positive PLR test (increase in CI ≥ 10%). We also tested whether CBF and FBF changes could track simultaneous changes in CI during PLR and volume expansion. In 51 cases, we measured CI (PiCCO2), CBF and FBF before and during a PLR test (one performed for CBF and another for FBF measurements) and before and after volume expansion, which was performed if PLR was positive.

Results

Due to poor echogenicity or insufficient Doppler signal quality, CBF could be measured in 39 cases and FBF in only 14 cases. A positive PLR response could not be detected by changes in CBF, FBF, carotid nor by femoral peak systolic velocities (areas under the receiver operating characteristic curves: 0.58 ± 0.10, 0.57 ± 0.16, 0.56 ± 0.09 and 0.64 ± 10, respectively, all not different from 0.50). The correlations between simultaneous changes in CI and CBF and in CI and FBF during PLR and volume expansion were not significant (p = 0.41 and p = 0.27, respectively).

Conclusion

Doppler measurements of CBF and of FBF, as well as measurements of their peak velocities, are not reliable to assess cardiac output and its changes.
Appendix
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Metadata
Title
Carotid and femoral Doppler do not allow the assessment of passive leg raising effects
Authors
Valentina Girotto
Jean-Louis Teboul
Alexandra Beurton
Laura Galarza
Thierry Guedj
Christian Richard
Xavier Monnet
Publication date
01-12-2018
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2018
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-018-0413-7

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