• Jin Xie, Li Xu, Ke Peng, Jun Chen, and Jingjie Wan.
• Intensive Care Unit of the Department of Anesthesiology, the First Affiliated Hospital of Soochow University, Suzhou, China.
• J. Cardiothorac. Vasc. Anesth. 2024 Feb 1; 38 (2): 459465459-465.

ObjectiveThe authors aimed to evaluate the precision of changes in systolic-pressure variation after passive leg raising (PLR) as a predictor of fluid responsiveness in postoperative critically ill patients, and to compare the precision of changes in pulse-pressure variation after PLR (ΔPPVPLR) with changes in systolic-pressure variation after PLR (ΔSPVPLR).DesignA prospective observational study.SettingA surgical intensive care unit of a tertiary hospital.ParticipantsSeventy-four postoperative critically ill patients with acute circulatory failure were enrolled.InterventionsFluid responsiveness was defined as an increase of 10% or more in stroke volume after PLR, dividing patients into 2 groups: responders and nonresponders.Measurement And Main ResultsHemodynamic data were recorded at baseline and after PLR, and the stroke volume was measured by transthoracic echocardiography. Thirty-eight patients were responders, and 36 were nonresponders. ΔPPVPLR predicted fluid responsiveness with an area under the receiver operating characteristic curve (AUC) of 0.917, and the optimal cutoff value was 2.3%, with a gray zone of 1.6% to 3.3%, including 19 (25.7%) patients. ΔSPVPLR predicted fluid responsiveness with an AUC of 0.908, and the optimal cutoff value was 1.9%, with a gray zone of 1.1% to 2.0%, including 18 (24.3%) patients. No notable distinction was observed between the AUC for ΔPPVPLR and ΔSPVPLR (p = 0.805) in predicting fluid responsiveness.ConclusionsΔSPVPLR and ΔPPVPLR could accurately predict fluid responsiveness in postoperative critically ill patients. There was no difference in the ability to predict fluid responsiveness between ΔSPVPLR and ΔPPVPLR.Copyright © 2023 Elsevier Inc. All rights reserved.

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