Passive Leg Raising After Left Ventricular Assist Device Implantation. Academic Article uri icon

Overview

abstract

  • Left ventricular assist device (LVAD) implantation is a common procedure in patients with end-stage heart failure. Although optimal fluid management is essential for acceptable postoperative treatment, it is critical to identify which patients will benefit from fluid administration. Passive leg raising (PLR) is a validated dynamic method that predicts fluid responsiveness in patients with heart failure by inducing a transient increase in cardiac preload. We performed a prospective study on 20 consecutive patients who underwent PLR maneuvers after LVAD implantation. Left ventricular assist device flow, end-tidal carbon dioxide, central venous pressure (CVP), and mean arterial pressure (MAP) were measured before and after PLR. Passive leg raising responsiveness was defined as at least a 15% increase in LVAD flow: (11 were responders and 9 nonresponders). Of the responders, 7 had right ventricular dysfunction (≥3). Passive leg raising responsiveness was associated with an increase of 19% in the LVAD flow, the mean CVP was raised from 11.3 to 14.4 mm Hg and the MAP from 82.6 to 86.7 mm Hg. After PLR, end-tidal carbon dioxide was increased by 4.6 mm Hg in the responders and 1.1 mm Hg in the nonresponders. The PLR maneuver is a noninvasive and easy to perform method that uses LVAD flow to assess fluid responsiveness in patients with heart failure after LVAD implantation.

authors

  • Ram, Eilon
  • Dourov, Daniil
  • Berkenstadt, Haim
  • Lavee, Jacob
  • Kassif, Yigal
  • Peled-Potashnik, Yael
  • Kogan, Dina
  • Preisman, Sergey
  • Raanani, Ehud
  • Kogan, Alexander

publication date

  • January 1, 2019

Research

keywords

  • Fluid Therapy
  • Heart Failure
  • Heart-Assist Devices

Identity

Scopus Document Identifier

  • 85071772619

Digital Object Identifier (DOI)

  • 10.1097/MAT.0000000000000870

PubMed ID

  • 30379654

Additional Document Info

volume

  • 65

issue

  • 7