TY - JOUR
T1 - Passive Leg Raising after Left Ventricular Assist Device Implantation
AU - Ram, Eilon
AU - Dourov, Daniil
AU - Berkenstadt, Haim
AU - Lavee, Jacob
AU - Kassif, Yigal
AU - Peled-Potashnik, Yael
AU - Kogan, Dina
AU - Preisman, Sergey
AU - Raanani, Ehud
AU - Kogan, Alexander
N1 - Publisher Copyright:
Copyright © 2019 American Society of Artificial Internal Organs.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Left ventricular assist device (LVAD) implantation is a common procedure in patients with end-stage heart failure. Although optimal fluid management is essential for acceptable postoperative treatment, it is critical to identify which patients will benefit from fluid administration. Passive leg raising (PLR) is a validated dynamic method that predicts fluid responsiveness in patients with heart failure by inducing a transient increase in cardiac preload. We performed a prospective study on 20 consecutive patients who underwent PLR maneuvers after LVAD implantation. Left ventricular assist device flow, end-tidal carbon dioxide, central venous pressure (CVP), and mean arterial pressure (MAP) were measured before and after PLR. Passive leg raising responsiveness was defined as at least a 15% increase in LVAD flow: (11 were responders and 9 nonresponders). Of the responders, 7 had right ventricular dysfunction (≥3). Passive leg raising responsiveness was associated with an increase of 19% in the LVAD flow, the mean CVP was raised from 11.3 to 14.4 mm Hg and the MAP from 82.6 to 86.7 mm Hg. After PLR, end-tidal carbon dioxide was increased by 4.6 mm Hg in the responders and 1.1 mm Hg in the nonresponders. The PLR maneuver is a noninvasive and easy to perform method that uses LVAD flow to assess fluid responsiveness in patients with heart failure after LVAD implantation.
AB - Left ventricular assist device (LVAD) implantation is a common procedure in patients with end-stage heart failure. Although optimal fluid management is essential for acceptable postoperative treatment, it is critical to identify which patients will benefit from fluid administration. Passive leg raising (PLR) is a validated dynamic method that predicts fluid responsiveness in patients with heart failure by inducing a transient increase in cardiac preload. We performed a prospective study on 20 consecutive patients who underwent PLR maneuvers after LVAD implantation. Left ventricular assist device flow, end-tidal carbon dioxide, central venous pressure (CVP), and mean arterial pressure (MAP) were measured before and after PLR. Passive leg raising responsiveness was defined as at least a 15% increase in LVAD flow: (11 were responders and 9 nonresponders). Of the responders, 7 had right ventricular dysfunction (≥3). Passive leg raising responsiveness was associated with an increase of 19% in the LVAD flow, the mean CVP was raised from 11.3 to 14.4 mm Hg and the MAP from 82.6 to 86.7 mm Hg. After PLR, end-tidal carbon dioxide was increased by 4.6 mm Hg in the responders and 1.1 mm Hg in the nonresponders. The PLR maneuver is a noninvasive and easy to perform method that uses LVAD flow to assess fluid responsiveness in patients with heart failure after LVAD implantation.
KW - critical care
KW - fluid therapy
KW - heart assist devices
UR - http://www.scopus.com/inward/record.url?scp=85071772619&partnerID=8YFLogxK
U2 - 10.1097/MAT.0000000000000870
DO - 10.1097/MAT.0000000000000870
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C2 - 30379654
AN - SCOPUS:85071772619
SN - 1058-2916
VL - 65
SP - 656
EP - 660
JO - ASAIO Journal
JF - ASAIO Journal
IS - 7
ER -