Title: Passive Leg Raise

Category: Critical Care

Keywords: passive leg raise, arterial pressure, pulse pressure variation, volume responsiveness, fluid resuscitation (PubMed Search)

Posted: 9/20/2016 by Mike Winters, MBA, MD

Pitfalls with PLR

The passive leg raise (PLR) test has become a popular method to assess volume responsiveness in critically ill patients.
PLR mobilizes a volume of approximately 150-300 mL and can be used in spontaneously breathing patients, those receiving positive pressure ventilation, or those with various arrhythmias.
In order to properly perform the PLR, you must have a method to monitor cardiac output. (See previously pearl on 7/26/16).
Pitfall: Simply monitoring arterial blood pressure alone is not a sufficient method to assess a positive PLR.
Pitfalls:Risks of performing a PLR include increased intracranial pressure, reduced cerebral blood flow, and decreased pulmonary compliance.

Aneman A, Sondergaard S. Understanding the passive leg raising test. Intensive Care Med. 2016; 42:1493-5.