| Title |
The passive leg raising test to guide fluid removal in critically ill patients
|
|---|---|
| Published in |
Annals of Intensive Care, May 2016
|
| DOI | 10.1186/s13613-016-0149-1 |
| Pubmed ID | |
| Authors |
Xavier Monnet, Flora Cipriani, Laurent Camous, Pierre Sentenac, Martin Dres, Evguenia Krastinova, Nadia Anguel, Christian Richard, Jean-Louis Teboul |
| Abstract |
To investigate whether haemodynamic intolerance to fluid removal during intermittent renal replacement therapy (RRT) in critically ill patients can be predicted by a passive leg raising (PLR) test performed before RRT. We included 39 patients where intermittent RRT with weight loss was decided. Intradialytic hypotension was defined as hypotension requiring a therapeutic intervention, as decided by the physicians in charge. Before RRT, the maximal increase in cardiac index (CI, pulse contour analysis) induced by a PLR test was recorded. RRT was then started. Ultrafiltration rate was similar in patients with and without intradialytic hypotension. Thirteen patients presented intradialytic hypotension, while 26 did not. In patients with intradialytic hypotension, it occurred 120 min [interquartile range 60-180 min] after onset of RRT. In the 26 patients without intradialytic hypotension, the PLR test induced no significant change in CI. Conversely, in patients with intradialytic hypotension, PLR significantly increased CI by 15 % [interquartile range 11-36 %]. The PLR-induced increase in CI predicted intradialytic hypotension with an area under the ROC curve of 0.89 (95 % interval confidence 0.75-0.97) (p < 0.05 from 0.50). The best diagnostic threshold was 9 %. The sensitivity was 77 % (95 % confidence interval 46-95 %), the specificity was 96 % (80-100 %), the positive predictive value was 91 % (57-100 %), and the negative predictive value was 89 % (72-98 %). Compared to patients without intolerance to RRT, CI decreased significantly faster in patients with intradialytic hypotension, with a slope difference of -0.17 L/min/m(2)/h. The presence of preload dependence, as assessed by a positive PLR test before starting RRT with fluid removal, predicts that RRT will induce haemodynamic intolerance. |
X Demographics
The data shown below were collected from the profiles of 49 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 | 8 | 16% |
| United States | 5 | 10% |
| Belgium | 3 | 6% |
| Nepal | 2 | 4% |
| Singapore | 1 | 2% |
| Russia | 1 | 2% |
| Canada | 1 | 2% |
| Colombia | 1 | 2% |
| South Africa | 1 | 2% |
| Other | 10 | 20% |
| Unknown | 16 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 34 | 69% |
| Practitioners (doctors, other healthcare professionals) | 8 | 16% |
| Scientists | 6 | 12% |
| Science communicators (journalists, bloggers, editors) | 1 | 2% |
Mendeley readers
The data shown below were compiled from readership statistics for 85 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Czechia | 1 | 1% |
| Unknown | 84 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 16 | 19% |
| Researcher | 9 | 11% |
| Student > Postgraduate | 8 | 9% |
| Student > Master | 7 | 8% |
| Student > Doctoral Student | 7 | 8% |
| Other | 25 | 29% |
| Unknown | 13 | 15% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 60 | 71% |
| Nursing and Health Professions | 6 | 7% |
| Engineering | 2 | 2% |
| Unspecified | 1 | 1% |
| Decision Sciences | 1 | 1% |
| Other | 1 | 1% |
| Unknown | 14 | 16% |
Attention Score in Context
This research output has an Altmetric Attention Score of 29. 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 30 November 2022.
All research outputs
#1,331,908
of 25,362,278 outputs
Outputs from Annals of Intensive Care
#152
of 1,195 outputs
Outputs of similar age
#23,914
of 348,529 outputs
Outputs of similar age from Annals of Intensive Care
#3
of 29 outputs
Altmetric has tracked 25,362,278 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,195 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 18.3. 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 29 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 93% of its contemporaries.