Evaluation of changes in mean arterial Pressure and pulse pressure following passive Leg rising test as index and predictor of fluid Responsiveness in septic shock patients

Abstract

ABSTRACT INTRODUCTION Intravenous volume expansion is a fundamental aspect of hemodynamic therapy for individuals with life-threatening conditions who have hypoperfusion. In sepsis, resuscitation protocols in the beginning of the diagnosis which includes fluid therapy can reduce the mortality. In patients with right or left ventricular dysfunction, the volume expansion can stimulate the edema in the periphery and lungs and can negatively impact the microvascular perfusion and oxygen delivery. For patients who are in preload unresponsive condition, a significant amount of volume expansion can worsen the pulmonary edema, induce respiratory failure, increase the time on mechanical ventilation and develops intra-abdominal hypertension. Passive leg rising is recommended as a method to shift venous blood from the legs to intrathoracic region and hence increasing the intrathoracic volume and cardiac preload. The aim of the study was to determine if mean arterial pressure and pulse pressure as a measurement could be used in conjunction with PLR to predict the hemodynamic response to volume expansion. The objective of the study was to study the efficiency of changes in mean arterial pressure and pulse pressure as predictors of fluid resuscitation response following passive leg rising test as an indicator of fluid resuscitation in septic shock patients.