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Passive leg-raising

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https://www.readbyqxmd.com/read/28050895/passive-leg-raise-testing-effectively-reduces-fluid-administration-in-septic-shock-after-correction-of-non-compliance-to-test-results
#1
Arjanne Rameau, Eldert de With, Evert Christiaan Boerma
BACKGROUND: Fluid resuscitation is considered a cornerstone of shock treatment, but recent data have underlined the potential hazards of fluid overload. The passive leg raise (PLR) test has been introduced as one of many strategies to predict 'fluid responsiveness.' The use of PLR testing is applicable to a wide range of clinical situations and has the potential to reduce fluid administration, since PLR testing is based upon (reversible) autotransfusion. Despite these theoretical advantages, data on the net effect on fluid balance as a result of PLR testing remain scarce...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28040236/-does-fasting-influence-preload-responsiveness-in-asa-1-and-2-volunteers
#2
Daniel Rodrigues Alves, Regina Ribeiras
INTRODUCTION: Preoperative fasting was long regarded as an important cause of fluid depletion, leading to haemodynamic instability during surgery should replenishment not be promptly instituted. Lately, this traditional point of view has been progressively challenged, and a growing number of authors now propose a more restrictive approach to fluid management, although doubt remains as to the true haemodynamic influence of preoperative fasting. METHODS: We designed an observational, analytic, prospective, longitudinal study in which 31 ASA 1 and ASA 2 volunteers underwent an echocardiographic examination both before and after a fasting period of at least 6h...
December 28, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28039242/non-invasive-assessment-of-fluid-responsiveness-using-cnap%C3%A2-technology-is-interchangeable-with-invasive-arterial-measurements-during-major-open-abdominal-surgery
#3
J Renner, M Gruenewald, M Hill, L Mangelsdorff, H Aselmann, C Ilies, M Steinfath, O Broch
BACKGROUND: Dynamic variables of fluid responsiveness (FR), such as pulse pressure variation (PPV), have been shown to predict the response to a fluid challenge accurately. A recently introduced non-invasive technology based on the volume-clamp method (CNAP™) offers the ability to measure PPV continuously (PPVCNAP). However, the accuracy regarding the prediction of FR in the operating room has to be proved. METHODS: We compared PPVCNAP with an invasive approach measuring PPV using the PiCCO technology (PPVPiCCO)...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28030505/ultrasound-assessment-of-volume-responsiveness-in-critically-ill-surgical-patients-two-measurements-are-better-than-one
#4
Sarah B Murthi, Syeda Fatima, Ashely R Menne, Jacob J Glaser, Samuel M Galvagno, Stephen Biederman, Stephen Biederman, Raymond Fang, Hegang Chen, Thomas M Scalea
BACKGROUND: The intended physiologic response to a fluid bolus is an increase in stroke volume (SV). Several ultrasound (US) measures have been shown to be predictive. The best measure(s) in critically ill surgical patients remains unclear. METHODS: This is a prospective observational study in critically ill surgical patients receiving a bolus of crystalloid, colloid or blood. A transthoracic echocardiogram (TTE) was performed before (pre-TTE) and after. A positive volume response (+VR) was defined as a ≥15% increase in SV...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28017352/the-influence-of-age-on-hemodynamic-parameters-during-rest-and-exercise-in%C3%A2-healthy-individuals
#5
Emil Wolsk, Rine Bakkestrøm, Jacob H Thomsen, Louise Balling, Mads J Andersen, Jordi S Dahl, Christian Hassager, Jakob E Møller, Finn Gustafsson
OBJECTIVES: The authors sought to obtain hemodynamic estimates across a wide age span and in both sexes for future reference and compare these estimates with current guideline diagnostic hemodynamic thresholds for abnormal filling pressure and pulmonary hypertension. BACKGROUND: At present, the influence of age on hemodynamic function is largely unknown. Because many diseases with proposed cardiac impact are more prevalent in the older population, it is pivotal to know how hemodynamic parameters are affected by age itself to discern the influence of disease from that of physiological aging...
November 30, 2016: JACC. Heart Failure
https://www.readbyqxmd.com/read/27992294/effects-of-a-novel-neurodynamic-tension-technique-on-muscle-extensibility-and-stretch-tolerance-a-counterbalanced-cross-over-study
#6
Max Pietrzak, Niels Bj Vollard
CONTEXT: Neurodynamic tension affects hamstring extensibility and stretch tolerance, and is considered important in hamstring injury management. Neurodynamic tension was postulated to affect segmental muscle extensibility and stretch tolerance, and potentially also demonstrate extra-segmental and contralateral effects. OBJECTIVES: Assess the effects of a novel sciatic-tibial neurodynamic tension technique, the modified long sit slump (MLSS), on segmental, extra-segmental and contralateral muscle extensibility and stretch tolerance...
December 19, 2016: Journal of Sport Rehabilitation
https://www.readbyqxmd.com/read/27987483/the-diagnostic-utility-of-sonographic-carotid-flow-time-in-determining-volume-responsiveness
#7
Hamid Shokoohi, Grant W Berry, Murteza Shahkolahi, Jackson King, Jordan King, Mohammad Salimian, Ameneh Poshtmashad, Ali Pourmand
OBJECTIVE: We aimed to predict volume responsiveness and to assess the diagnostic accuracy of carotid flow time (FTc) with the change in hydration status before and after a passive leg raise (PLR) maneuver. METHODS: Participants who presented at a community health fair in a dehydrated state following a prolonged fast while observing the month of Ramadan were recruited. Sonographic FTc measurements were obtained in the semi-Fowler position and after a PLR maneuver while participants were in a fasting state and repeated approximately 3 hours after breaking their fast...
November 9, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27984249/predicting-fluid-responsiveness-in-acute-liver-failure-a-prospective-study
#8
Vinod Kumar Audimoolam, Mark J W McPhail, Chris Willars, William Bernal, Julia A Wendon, Maurizio Cecconi, Georg Auzinger
BACKGROUND: The profound hemodynamic changes seen in acute liver failure (ALF) resemble the hyperdynamic state found in the later stages of septic shock. Vasopressor support frequently is required after initial volume therapy. Markers of preload dependency have not been studied in this patient group. Dynamic maneuvers such as passive leg raising or end-expiratory hold, which have shown good predictive accuracy in a general intensive care unit population, cannot be considered safe in this cohort because of the concerns of intracranial hypertension...
December 14, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27981285/utility-of-transthoracic-echocardiography-tte-in-assessing-fluid-responsiveness-in-critically-ill-patients-a-challenge-for-the-bedside-sonographer
#9
Wojciech Mielnicki, Agnieszka Dyla, Tomasz Zawada
Transthoracic echocardiography (TTE) has become one of the most important diagnostic tools in the treatment of critically ill patients. It allows clinicians to recognise potentially reversible life-threatening situations and is also very effective in the monitoring of the fluid status of patients, slowly substituting invasive methods in the intensive care unit. Hemodynamic assessment is based on a few static and dynamic parameters. Dynamic parameters change during the respiratory cycle in mechanical ventilation and the level of this change directly corresponds to fluid responsiveness...
December 5, 2016: Medical Ultrasonography
https://www.readbyqxmd.com/read/27858914/values-of-hemodynamic-variation-in-response-to-passive-leg-raising-in-predicting-exercise-capacity-of-heart-failure-with-preserved-ejection-fraction
#10
Hong-Lian Zhou, Ling Ding, Tao Mi, Kai Zheng, Xiao-Fen Wu, Jing Wang, Meng-Ying Liu, Le Zhang, Cun-Tai Zhang, Xiao-Qing Quan
In heart failure patients with preserved ejection fraction, their hemodynamic parameters usually change when they are from recumbent to passive leg raising. The authors designed this study to investigate the relationship between hemodynamic parameters measured by impedance cardiography (ICG) and 6-minute walk distance (6MWD) of heart failure with preserved ejection fraction (HFPEF). We recruited 49 subjects with HFPEF in the study, and all the subjects were separated into 2 groups: the patients whose hemodynamic parameters rose after passive leg raising were in group 1 (n = 26) and the patients whose hemodynamic parameters did not rise after passive leg raising were in group 2 (n = 23)...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27858374/prediction-of-fluid-responsiveness-an-update
#11
REVIEW
Xavier Monnet, Paul E Marik, Jean-Louis Teboul
In patients with acute circulatory failure, the decision to give fluids or not should not be taken lightly. The risk of overzealous fluid administration has been clearly established. Moreover, volume expansion does not always increase cardiac output as one expects. Thus, after the very initial phase and/or if fluid losses are not obvious, predicting fluid responsiveness should be the first step of fluid strategy. For this purpose, the central venous pressure as well as other "static" markers of preload has been used for decades, but they are not reliable...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27836002/cardiac-dysfunction-induced-by-weaning-from-mechanical-ventilation-incidence-risk-factors-and-effects-of-fluid-removal
#12
Jinglun Liu, Feng Shen, Jean-Louis Teboul, Nadia Anguel, Alexandra Beurton, Nadia Bezaz, Christian Richard, Xavier Monnet
BACKGROUND: Weaning-induced pulmonary oedema (WiPO) is a well-recognised cause of failure of weaning from mechanical ventilation, but its incidence and risk factors have not been reliably described. We wanted to determine the incidence and risk factors in a population of critically ill patients. In addition, we wanted to describe the effects of diuretics when they are administered in this context. METHODS: We monitored 283 consecutive spontaneous breathing trials (SBT; T-piece trial) performed in 81 patients...
November 12, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27766613/carotid-doppler-flowmetry-correlates-poorly-with-thermodilution-cardiac-output-following-cardiac-surgery
#13
C Roehrig, M Govier, J Robinson, A Aneman
BACKGROUND: It remains unclear whether measuring carotid arterial flow by the time velocity integral using vascular Doppler ultrasound can be used to monitor cardiac output and volume responsiveness. METHODS: The carotid Doppler flow (time velocity integral and peak flow velocity variation) was assessed in triplicate by an intensivist with formal vascular ultrasound training. Thirty-three patients admitted following coronary by-pass surgery were studied before and after a passive leg-raising manoeuvre to investigate volume responsiveness (more than 10% increase in cardiac output) along with indices of arterial load measuring cardiac output by thermodilution...
January 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27765870/acute-achilles-tendon-rupture-treated-by-double-side-locking-loop-suture-technique-with-early-rehabilitation
#14
Wataru Miyamoto, Shinji Imade, Ken Innami, Hirotaka Kawano, Masato Takao
BACKGROUND: Although early accelerated rehabilitation is recommended for the treatment of acute Achilles tendon rupture, most traditional rehabilitation techniques require some type of brace. METHODS: We retrospectively analyzed 44 feet of 44 patients (25 male and 19 female) with a mean age of 31.8 years who had an acute Achilles tendon rupture related to athletic activity. Patients had been treated by a double side-locking loop suture (SLLS) technique using double antislip knots between stumps and had undergone early accelerated rehabilitation, including active and passive range of motion exercises on the day following the operation and full weight-bearing at 4 weeks...
October 10, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27748729/effects-of-passive-leg-raising-on-microvascular-venous-compartment-in-critically-ill-patients
#15
Roberto A DE Blasi, Roberto Arcioni, Domitilla Brancadoro, Monica Rocco
BACKGROUND: Even though fluid loading is thought to improve organ perfusion, the way in which it does so remains unclear. We assessed how the microvascular bed in skeletal muscle reacts to passive leg raising in patients with and without sepsis or septic shock. METHODS: We studied 40 critically ill patients (group A) and 30 healthy controls (group B). The forearm microvascular bed was assessed using near-infrared spectroscopy before and after passive leg raising...
October 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27721980/fluid-responsiveness-prediction-using-vigileo-flotrac-measured-cardiac-output-changes-during-passive-leg-raise-test
#16
Anton Krige, Martin Bland, Thomas Fanshawe
BACKGROUND: Passive leg raising (PLR) is a so called self-volume challenge used to test for fluid responsiveness. Changes in cardiac output (CO) or stroke volume (SV) measured during PLR are used to predict the need for subsequent fluid loading. This requires a device that can measure CO changes rapidly. The Vigileo™ monitor, using third-generation software, allows continuous CO monitoring. The aim of this study was to compare changes in CO (measured with the Vigileo device) during a PLR manoeuvre to calculate the accuracy for predicting fluid responsiveness...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27673307/will-this-hemodynamically-unstable-patient-respond-to-a-bolus-of-intravenous-fluids
#17
REVIEW
Peter Bentzer, Donald E Griesdale, John Boyd, Kelly MacLean, Demetrios Sirounis, Najib T Ayas
IMPORTANCE: Fluid overload occurring as a consequence of overly aggressive fluid resuscitation may adversely affect outcome in hemodynamically unstable critically ill patients. Therefore, following the initial fluid resuscitation, it is important to identify which patients will benefit from further fluid administration. OBJECTIVE: To identify predictors of fluid responsiveness in hemodynamically unstable patients with signs of inadequate organ perfusion. DATA SOURCES AND STUDY SELECTION: Search of MEDLINE and EMBASE (1966 to June 2016) and reference lists from retrieved articles, previous reviews, and physical examination textbooks for studies that evaluated the diagnostic accuracy of tests to predict fluid responsiveness in hemodynamically unstable adult patients who were defined as having refractory hypotension, signs of organ hypoperfusion, or both...
September 27, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27632868/associations-between-functional-and-isolated-performance-measures-in-collegiate-women-s-soccer-players
#18
Ryan S McCann, Kyle B Kosik, Masafumi Terada, Megan Q Beard, Gretchen E Buskirk, Phillip A Gribble
CONTEXT: The Star Excursion Balance Test (SEBT) and Functional Movement Screen (FMS) are functional performance measures capable of predicting lower extremity injury risk. While suboptimal SEBT and FMS performances are influenced by multiple factors, the contribution of hip strength and flexibility to these tests is mostly unknown. Examination of hip strength and flexibility influences on the SEBT and FMS may direct clinicians to better methods of correcting functional deficits. OBJECTIVE: Determine the relationships of isometric hip strength and hip passive range of motion (PROM) with functional performance measures...
August 24, 2016: Journal of Sport Rehabilitation
https://www.readbyqxmd.com/read/27601786/physical-performance-of-elite-and-subelite-spanish-female-futsal-players
#19
D J Ramos-Campo, J A Rubio-Arias, M Carrasco-Poyatos, P E Alcaraz
The aim of this study was to determine the parameters distinguishing top female futsal players from lower level players. Twenty-seven female futsal players participated in the study, composed of professional first division (elite; n = 15) players and semi-professional second division players (sub-elite; n = 14). Active and passive straight leg raise tests, isokinetic strength of the knee extensor and flexor muscles at 60° · s(-1) angular velocity, squat and counter movement jumps, 30 m sprint, 30 m agility, repeated sprint ability test and maximum ball speed during shooting were measured...
September 2016: Biology of Sport
https://www.readbyqxmd.com/read/27592289/echocardiography-as-a-guide-for-fluid-management
#20
REVIEW
John H Boyd, Demetrios Sirounis, Julien Maizel, Michel Slama
BACKGROUND: In critically ill patients at risk for organ failure, the administration of intravenous fluids has equal chances of resulting in benefit or harm. While the intent of intravenous fluid is to increase cardiac output and oxygen delivery, unwelcome results in those patients who do not increase their cardiac output are tissue edema, hypoxemia, and excess mortality. Here we briefly review bedside methods to assess fluid responsiveness, focusing upon the strengths and pitfalls of echocardiography in spontaneously breathing mechanically ventilated patients as a means to guide fluid management...
September 4, 2016: Critical Care: the Official Journal of the Critical Care Forum
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