Hemodynamic effects of passive leg raising: an echocardiographic study in patients with shock.
Intensive Care Med
; 34(7): 1239-45, 2008 Jul.
Article
en En
| MEDLINE
| ID: mdl-18351322
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 (DeltaSVC).RESULTS:
Forty patients with shock, sedated and mechanically ventilated, were included. Transesophageal echocardiography was performed. At baseline (T1), two groups were defined according to DeltaSVC. Eighteen patients presenting a DeltaSVC > 36%, an indicator of preload dependency, formed group 1, whereas 22 patients (group 2) exhibited a DeltaSVC < 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, DeltaSVC was significantly higher in group 1 than in group 2, 50 +/- 9% and 7 +/- 6%, respectively. In group 1, we found a decrease in DeltaSVC 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/m(2) (T4) and left ventricular end-diastolic volume from 51 +/- 41 to 61 +/- 51 and 73 +/- 51 ml/m(2). 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.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Choque
/
Vena Cava Superior
/
Ecocardiografía Transesofágica
/
Hemodinámica
/
Pierna
Límite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Año:
2008
Tipo del documento:
Article