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  • Passive leg raising may serve as the primary method to quickly assess fluid responsiveness in haemodynamically unstable patients

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Diagnosis
Commentary
Passive leg raising may serve as the primary method to quickly assess fluid responsiveness in haemodynamically unstable patients
  1. Thomas GV Cherpanath
  1. Correspondence to: Dr Thomas GV Cherpanath, Department of Intensive Care Medicine, University of Amsterdam, Amsterdam 1105AZ, The Netherlands; t.g.cherpanath{at}amc.uva.nl

https://doi.org/10.1136/ebmed-2016-110623

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    Commentary on: Bentzer P, Griesdale DE, Boyd J, et al. Will this hemodynamically unstable patient respond to a bolus of intravenous fluids? JAMA 2016;316:1298–309.OpenUrl

    Context

    Administration of intravenous fluids still serves as the cornerstone of haemodynamic resuscitation, yet both insufficient as well as overzealous fluid loading can increase morbidity and mortality. Correctly predicting fluid responsiveness is thus of the utmost importance, especially since only half of critically ill patients positively respond to a fluid bolus. Bentzer et al investigated the diagnostic performance of different methods in predicting fluid responsiveness.

    Methods

    Using MEDLINE and EMBASE, a total of 651 studies were identified investigating different methods to predict fluid responsiveness in haemodynamic unstable patients with refractory hypotension and/or signs of organ hypoperfusion. After exclusion of lower quality studies, trials with ≤20 patients and studies performed in elective cardiothoracic surgery patients, a systematic review and …

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    Footnotes

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.