Passive Leg Raising (PLR)

• We have discussed that static measures of volume (CVP, PA wedge pressures) are not reliable markers of fluid responsiveness
• PLR has recently gained interest as a simple and transient way to assess fluid responsiveness in the critically ill
• Patients are placed in the horizontal position (not Trendelenburg) and the legs are raised to 45 degrees
• A hemodynamic response should be seen in 30 - 90 seconds
• Patients who have improvement in hemodynamics with PLR are said to be fluid responsive (i.e on the ascending portion of their Starling Curve) and require additional volume resuscitation

References

Monnet X, Teboul JL. Passive leg raising. Intensive Care Med 2008;34:659-63.