Prediction of Fluid Responsiveness using a complete and partial Passive Leg Raising maneuver in post-cardiac surgery patients Article Swipe
Loek P.B. Meijs
,
Alexander J. G. H. Bindels
,
Arnout N. Roos
,
Saskia Houterman
,
Samuel Heuts
,
Joris van Houte
,
Jan Bakker
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.21203/rs.3.rs-4460439/v1
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.21203/rs.3.rs-4460439/v1
Background Prediction of fluid responsiveness (FR) in critically ill patients is challenging. Passive leg raising (PLR) has been proven to adequately predict FR. PLR consists of a thoracic (T-PLR) and a limb (L-PLR) movement. Since a complete PLR (C-PLR) is not always feasible, this study focused on investigating the predictive value of partial PLRs on FR. Methods A prospective, observational study was performed in 40 post-cardiac surgery patients. C-PLR was performed, followed by a T-PLR, L-PLR and fluid challenge (FC). Invasive cardiac index (CI) measurements were continuously recorded during all maneuvers. FR was defined as a CI-increase ≥ 15% after FC, thereby identifying responders (R) and non-responders (NR). The predictive value of the PLR-elements was assessed with receiver operating characteristic (ROC) curves. Changes over time were analyzed with generalized linear model (GLM) analyses. Intraclass correlation coefficient (ICC) was used to assess absolute agreement between PLR and FC. Results Forty patients were included (35 R / 5 NR). AUC was similar for all PLRs (C-PLR = 0.84; T-PLR = 0.86, L-PLR = 0.86). ICCs between FC versus the three PLRs were 0.81 (0.63–0.90), 0.78 (0.59–0.88), and 0.71 (0.46–0.85), respectively. Median CI-increase during C-PLR was 27.8% (21–48%) in responders vs. 10.7% (7.5–12.6%) in non-responders (p = 0.012). After FC, median CI-increase was 30.0% (22.2–42.9%) in responders vs. 7.4% (6.3–12.4%) in non-responders (p = 0.002). Conclusion Partial PLRs have similar predictive values compared to a C-PLR. This could improve the prediction of FR in specific patient categories where C-PLR is restricted.
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Metadata
- Type
- preprint
- Language
- en
- Landing Page
- https://doi.org/10.21203/rs.3.rs-4460439/v1
- https://www.researchsquare.com/article/rs-4460439/latest.pdf
- OA Status
- green
- References
- 20
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4399477730
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4399477730Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.21203/rs.3.rs-4460439/v1Digital Object Identifier
- Title
-
Prediction of Fluid Responsiveness using a complete and partial Passive Leg Raising maneuver in post-cardiac surgery patientsWork title
- Type
-
preprintOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-06-10Full publication date if available
- Authors
-
Loek P.B. Meijs, Alexander J. G. H. Bindels, Arnout N. Roos, Saskia Houterman, Samuel Heuts, Joris van Houte, Jan BakkerList of authors in order
- Landing page
-
https://doi.org/10.21203/rs.3.rs-4460439/v1Publisher landing page
- PDF URL
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https://www.researchsquare.com/article/rs-4460439/latest.pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
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greenOpen access status per OpenAlex
- OA URL
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https://www.researchsquare.com/article/rs-4460439/latest.pdfDirect OA link when available
- Concepts
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Medicine, Receiver operating characteristic, Intraclass correlation, Cardiac surgery, Predictive value, Prospective cohort study, Predictive value of tests, Meta-analysis, Observational study, Internal medicine, Critically ill, Surgery, Cardiology, Psychometrics, Clinical psychologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- References (count)
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20Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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