Original Article
Bioreactance-based passive leg raising test can predict fluid responsiveness in elderly patients with septic shock
Abstract
Background: Few studies have reported the value of volume responsiveness evaluation on bioreactance-based passive leg raising (PLR) test in elderly patients.This study was carried out to determinate the predictive value of bioreactance-based PLR test for predicting fluid responsiveness (FR) of elderly patients with septic shock, and to compare it to central venous pressure (CVP).
Methods: This prospective, single-centre study enrolled 50 elderly patients with septic shock from the Department of Critical Care Medicine of Zhejiang Hospital, Hangzhou, China, from October 2012 to October 2015. All patients underwent PLR test and fluid infusion test sequentially. Noninvasive cardiac output monitoring (NICOM) was used to continuously record hemodynamic parameters such as cardiac output (CO), heart rate (HR) and CVP, at baseline 1, PLR, baseline 2, and volume expansion (VE). FR is defined as the change in CO (ΔCO) ≥10% after the fluid infusion test.
Results: CO clearly increased after PLR and VE (5.21±2.34 vs. 6.03±2.73, P<0.05; 5.09±1.99 vs. 5.60±2.11, P<0.05). The PLR induced change in CO (ΔCOPLR) and VE induced change in CO (ΔCOVE) were highly correlated [r=0.80 (0.64–0.90)], while the CVP and ΔCOVE were uncorrelated [r=0.12 (−0.16–0.32)]. The areas under the ROC curves of ΔCOPLR and CVP predicting FR were 0.868 and 0.514 respectively. ΔCOPLR ≥10% was found to predict FR with a sensitivity of 86% and a specificity of 79%.
Conclusions: Bioreactance-based PLR tests could predict FR of elderly patients with septic shock, while CVP could not.
Methods: This prospective, single-centre study enrolled 50 elderly patients with septic shock from the Department of Critical Care Medicine of Zhejiang Hospital, Hangzhou, China, from October 2012 to October 2015. All patients underwent PLR test and fluid infusion test sequentially. Noninvasive cardiac output monitoring (NICOM) was used to continuously record hemodynamic parameters such as cardiac output (CO), heart rate (HR) and CVP, at baseline 1, PLR, baseline 2, and volume expansion (VE). FR is defined as the change in CO (ΔCO) ≥10% after the fluid infusion test.
Results: CO clearly increased after PLR and VE (5.21±2.34 vs. 6.03±2.73, P<0.05; 5.09±1.99 vs. 5.60±2.11, P<0.05). The PLR induced change in CO (ΔCOPLR) and VE induced change in CO (ΔCOVE) were highly correlated [r=0.80 (0.64–0.90)], while the CVP and ΔCOVE were uncorrelated [r=0.12 (−0.16–0.32)]. The areas under the ROC curves of ΔCOPLR and CVP predicting FR were 0.868 and 0.514 respectively. ΔCOPLR ≥10% was found to predict FR with a sensitivity of 86% and a specificity of 79%.
Conclusions: Bioreactance-based PLR tests could predict FR of elderly patients with septic shock, while CVP could not.
