Femoral artery velocity change during passive leg raising can predict fluid responsiveness

doi:10.3969/j.issn.1002-1949.2014.08.006

Abstract：Objective Adequate fluid resuscitation is the key to the therapy of sepsis and other forms of septic shock commonly encountered in the intensive care unit (ICU).The present study aims to investigate the feasibility and accuracy of beside ultrasound measuring the variation of femoral artery peak velocity (ΔPeak-FA) combined with passive leg raising ( PLR) experiment in the evaluation of fluid responsiveness .Methods During a 7 -month period from January to July 2013 , we prospectively studied 55 patients enrolled into our ICU with spontaneous breathing ( SB ) during mechanical ventilation.We assessed hemodynamic status at baseline , after PLR, and after volume expansion (VE, 500 ml hydroxyethyl starch over 30 mins) by ultrasound.Patients were classified as responders if the variation of SV increase (ΔSVVE)≥15% after 500 mL volume expansion as the gold standard of fluid responsiveness .By analyzed the sensitivity , specificity and likelihood ratios of receiver operating characteristic ( ROC) curves of ΔPeak-FA, the feasibility and the accuracy of the diagnosis clinical study in predicting volume responsiveness was estimated .Results Among them after VE , ΔSVVE≥15%in 27 patients defined as responders and the rest 23 did not respond.After PLR, the area under the ROC of ΔPeak -FA was 0.858 ±0.054(P <0.01), and the ΔPeak -FA >13% predicted fluid responsiveness with a sensitivity of 67%, specificity of 96%, positive predictive value of 94%, and negative predictive value of 74%, respectively .Conclusion Measurement of ΔPeak -FA combined with PLR experiment with bedside ultrasound can accurately estimate the fluid status of the patient in ICU, and it is easy to be performed by the residents of ICU .In the future, it can be used in clinical practice.