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Updated: Mar 27, 2026
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Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
Published on: January 20, 2023
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Assessing Fluid Responsiveness in Spontaneously Breathing Patients.
Joseph Miller1,2, Chuan-Xing Ho2, Joy Tang2
1Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI.
Summary
Fasting volunteers showed fluid responsiveness using noninvasive methods. The passive leg raise (PLR) maneuver accurately predicted this fluid responsiveness in healthy subjects.
Area of Science:
- Critical Care Medicine
- Physiology
- Hemodynamics
Background:
- Fluid responsiveness assessment is crucial in critical care.
- Noninvasive methods are desirable for hemodynamic monitoring.
- The passive leg raise (PLR) maneuver is a potential fluid responsiveness predictor.
Purpose of the Study:
- To evaluate fluid responsiveness in fasting volunteers using noninvasive hemodynamic measurements.
- To assess the passive leg raise (PLR) maneuver's efficacy in predicting fluid responsiveness.
Main Methods:
- Quasi-experimental design with healthy volunteers after a 12-hour fast.
- Noninvasive, continuous pulse contour analysis for hemodynamic monitoring.
- Passive leg raise (PLR) maneuver followed by crystalloid bolus; stroke volume change ≥ 10% defined fluid responsiveness.
Main Results:
- 90% of subjects (36/40) were fluid responsive, with a mean stroke volume increase of 19% after fluid bolus.
- The PLR maneuver elicited a mean stroke volume increase of 16%.
- PLR demonstrated 72% sensitivity and 100% specificity for predicting fluid responsiveness.
Conclusions:
- Noninvasive assessment of fluid responsiveness is feasible in fasting volunteers.
- The passive leg raise (PLR) maneuver effectively predicts fluid responsiveness in this population.
- Further research is needed to validate these findings in critically ill patients.
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