| Title |
Effects of passive leg raising and volume expansion on mean systemic pressure and venous return in shock in humans
|
|---|---|
| Published in |
Critical Care, December 2015
|
| DOI | 10.1186/s13054-015-1115-2 |
| Pubmed ID | |
| Authors |
Laurent Guérin, Jean-Louis Teboul, Romain Persichini, Martin Dres, Christian Richard, Xavier Monnet |
| Abstract |
The aim of this study was to assess how mean systemic pressure (Psm) and resistance to venous return (Rvr) behave during passive leg raising (PLR) in cases of fluid responsiveness and fluid unresponsiveness. In 30 patients with an acute circulatory failure, in order to estimate the venous return curve, we constructed the regression line between pairs of cardiac index (CI) and central venous pressure (CVP). Values were measured during end-inspiratory and end-expiratory ventilatory occlusions performed at two levels of positive end-expiratory pressure. The x-axis intercept was used to estimate Psm and the inverse of the slope to quantify Rvr. These measurements were obtained at baseline, during PLR and after fluid infusion. Patients in whom fluid infusion increased CI by more than 15 % were defined as "fluid-responders". In fluid-responders (n = 15), CVP and Psm significantly increased (from 7 ± 3 to 9 ± 4 mmHg and from 25 ± 13 to 31 ± 13 mmHg, respectively) during PLR. The Psm-CVP gradient significantly increased by 20 ± 30 % while Rvr did not change significantly during PLR. In fluid-nonresponders, CVP and Psm increased significantly but the Psm-CVP gradient did not change significantly during PLR. PLR did not change the intra-abdominal pressure in the whole population (14 ± 6 mmHg before vs. 13 ± 5 mmHg during PLR, p = 0.26) and in patients with intra-abdominal hypertension at baseline (17 ± 4 mmHg before vs. 16 ± 4 mmHg during PLR, p = 0.14). In the latter group, PLR increased Psm from 22 ± 11 to 27 ± 10 mmHg (p <0.01) and did not change Rvr (5.1 ± 2.6 to 5.2 ± 3 mmHg/min/m(2)/mL, p = 0.71). In fluid-responders, Psm, CVP and the Psm-CVP gradient significantly increased during fluid infusion while the Rvr did not change. In fluid-nonresponders, CVP and Psm increased significantly during fluid infusion while the Psm-CVP gradient and Rvr did not change. PLR significantly increased Psm without modifying Rvr. This was also the case in patients with intra-abdominal hypertension. In case of fluid responsiveness, PLR increased venous return by increasing Psm to a larger extent than CVP. In patients with fluid unresponsiveness, PLR increased Psm but did not change the Psm-CVP gradient. Fluid infusion induced similar effects on Psm and Rvr. |
X Demographics
The data shown below were collected from the profiles of 64 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 9 | 14% |
| United States | 7 | 11% |
| Spain | 6 | 9% |
| Costa Rica | 3 | 5% |
| Mexico | 2 | 3% |
| Italy | 2 | 3% |
| South Africa | 1 | 2% |
| Australia | 1 | 2% |
| Denmark | 1 | 2% |
| Other | 7 | 11% |
| Unknown | 25 | 39% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 39 | 61% |
| Practitioners (doctors, other healthcare professionals) | 17 | 27% |
| Scientists | 5 | 8% |
| Science communicators (journalists, bloggers, editors) | 3 | 5% |
Mendeley readers
The data shown below were compiled from readership statistics for 107 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Chile | 1 | <1% |
| Unknown | 106 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 14 | 13% |
| Student > Master | 13 | 12% |
| Other | 12 | 11% |
| Student > Postgraduate | 11 | 10% |
| Student > Ph. D. Student | 10 | 9% |
| Other | 24 | 22% |
| Unknown | 23 | 21% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 67 | 63% |
| Nursing and Health Professions | 7 | 7% |
| Agricultural and Biological Sciences | 4 | 4% |
| Engineering | 2 | 2% |
| Computer Science | 1 | <1% |
| Other | 1 | <1% |
| Unknown | 25 | 23% |
Attention Score in Context
This research output has an Altmetric Attention Score of 38. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 May 2023.
All research outputs
#1,062,873
of 25,374,647 outputs
Outputs from Critical Care
#839
of 6,554 outputs
Outputs of similar age
#17,715
of 395,408 outputs
Outputs of similar age from Critical Care
#52
of 466 outputs
Altmetric has tracked 25,374,647 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,554 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.8. This one has done well, scoring higher than 87% of its peers.
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We're also able to compare this research output to 466 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 88% of its contemporaries.