• Hongjie Tong, Caibao Hu, Xuejing Hao, Guolong Cai, Qun Rao, Molei Yan, Jin Chen, and Jing Yan.
• Department of Critical Care Medicine, Zhejiang Hospital, Hangzhou 310013, China. Email:caiguolong725@hotmail.com.
• Zhonghua Nei Ke Za Zhi. 2015 Feb 1;54(2):130-3.

ObjectiveTo investigate the value of bioreactance-based passive leg raising (PLR) test predicting fluid responsiveness of elderly patients with sepsis.MethodsThis prospective and self-controlled clinical study included 31 elderly patients with sepsis in the Department of Intensive Care Medicine of Zhejiang Hospital. Hemodynamic parameters including cardiac output (CO), stroke volume variation (SVV) were continuously recorded by bioreactance-based device (noninvasive cardiac output monitoring, NICOM) before and after PLR and volume expansion (VE) test. Patients were defined as responders if CO increased ≥ 10% after VE.ResultsA total of 100 PLR and VE tests in these 31 patients were evaluated.In 28 responders, CO[(5.11 ± 2.10) L/min vs (5.91 ± 2.45) L/min, P < 0.05; (5.06 ± 2.06) L/min vs (5.77 ± 2.47) L/min, P < 0.05] and SV [(59.61 ± 18.22) ml vs (69.29 ± 21.32) ml, P < 0.05; (60.10 ± 15.95) ml vs (70.06 ± 17.96) ml, P < 0.05] were obviously increased both after PLR and VE. The ΔCO after PLR (ΔCOPLR) and ΔCOVE was highly correlated (r = 0.819, P = 0.001) while the SVV before VE and Δ COVE was uncorrelated (r = -0.218, P = 0.059). The areas under the ROC curve of ΔCOPLR, SVV predicting fluid responsiveness were 0.859 and 0.459 respectively. The ΔCOPLR ≥ 10% was found to predict fluid responsiveness with a sensitivity and specificity of 85% and 83% respectively.ConclusionCompared with SVV, PLR test is a simple, effective method for accurately predicting fluid responsiveness of elderly patients with sepsis.

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