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Pitfalls with PLR
- The passive leg raise (PLR) test has become a popular method to assess volume responsiveness in critically ill patients.
- PLR mobilizes a volume of approximately 150-300 mL and can be used in spontaneously breathing patients, those receiving positive pressure ventilation, or those with various arrhythmias.
- In order to properly perform the PLR, you must have a method to monitor cardiac output. (See previously pearl on 7/26/16).
- Pitfall: Simply monitoring arterial blood pressure alone is not a sufficient method to assess a positive PLR.
- Pitfalls:Risks of performing a PLR include increased intracranial pressure, reduced cerebral blood flow, and decreased pulmonary compliance.
References
Aneman A, Sondergaard S. Understanding the passive leg raising test. Intensive Care Med. 2016; 42:1493-5.