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Fluid responsiveness predicted by noninvasive Bioreactance-based passive leg raise test

Intensive care medicine, 2010-11, Vol.36 (11), p.1875-1881 [Peer Reviewed Journal]

Copyright jointly held by Springer and ESICM 2010 ;2015 INIST-CNRS ;COPYRIGHT 2010 Springer ;ISSN: 0342-4642 ;EISSN: 1432-1238 ;DOI: 10.1007/s00134-010-1990-6 ;PMID: 20665001 ;CODEN: ICMED9

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Title:
Fluid responsiveness predicted by noninvasive Bioreactance-based passive leg raise test
Author: Benomar, Brahim ; Ouattara, Alexandre ; Estagnasie, Philippe ; Brusset, Alain ; Squara, Pierre
Subjects: Aged ; Analysis ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthesiology ; Bacterial diseases ; Bacterial diseases of the genital system ; Biological and medical sciences ; Cardiac Output - physiology ; Cardiac patients ; Cardiovascular equipment ; Critical Care Medicine ; Emergency Medicine ; Female ; Hemodynamics - physiology ; Human bacterial diseases ; Humans ; Infectious diseases ; Intensive ; Intensive care medicine ; Intensive Care Units ; Leg - physiopathology ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Monitoring, Physiologic - instrumentation ; Movement ; Original ; Pain Medicine ; Pediatrics ; Pneumology/Respiratory System ; Prospective Studies ; Supine Position
Is Part Of: Intensive care medicine, 2010-11, Vol.36 (11), p.1875-1881
Description: Purpose To study the feasibility of predicting fluid responsiveness (FR) by passive leg raising (PLR) using a Bioreactance-based noninvasive cardiac output monitoring device (NICOM). Method This prospective, two-center study included 75 consecutive intensive care unit (ICU) adult patients immediately after cardiac surgery. NICOM was used to continuously record cardiac output (CO) at baseline, during a PLR, and then during a 500 ml i.v. rapid colloid infusion. We estimated the precision of NICOM at baseline to derive the least minimum significant change (LMSC) in CO. We studied the predictability of PLR for FR by systematic analysis of different categorizations of PLR and FR, based on percentage change in CO (from 0 to 20%). Results The LMSC was 8.85%. CO was 4.17 ± 1.04 L min −1 at baseline, 4.38 ± 1.14 L min −1 during PLR, 4.16 ± 1.08 L min −1 upon return to baseline, and 4.85 ± 1.41 L min −1 after fluid infusion. The change in CO following fluid bolus was highly correlated with the change in CO following PLR: y = 0.91 x + 4.3, r = 0.77. The Pearson correlation coefficient showed that the best pair of thresholds was found for PLR ≥0% predicting FR ≥0%. Using this pair of thresholds, PLR had 88% sensitivity and 100% specificity for predicting FR. When we restricted the analysis to change in CO > LMSC, the best pair of thresholds was obtained for PLR >9% predicting FR >9%. Using this pair of thresholds, PLR sensitivity was reduced to 68% and specificity to 95%. Conclusions In this specific population of patients, it is clinically valid to use the bioreactance-based NICOM system to predict FR from changes in CO during PLR.
Publisher: Berlin/Heidelberg: Springer-Verlag
Language: English
Identifier: ISSN: 0342-4642
EISSN: 1432-1238
DOI: 10.1007/s00134-010-1990-6
PMID: 20665001
CODEN: ICMED9
Source: MEDLINE
Alma/SFX Local Collection
ProQuest Central

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Fluid responsiveness predicted by noninvasive Bioreactance-based passive leg raise test

Copyright jointly held by Springer and ESICM 2010 ;2015 INIST-CNRS ;COPYRIGHT 2010 Springer ;ISSN: 0342-4642 ;EISSN: 1432-1238 ;DOI: 10.1007/s00134-010-1990-6 ;PMID: 20665001 ;CODEN: ICMED9

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