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| The value of changes in transcutaneous partial pressure of oxygen induced by passive leg raising in evaluating fluid responsiveness |
| Fang Hong－long, Wu Hua－yong, Chen Juan, Luo Jian, WangDan－qiong, Zhang Wei－wen. |
| Intensive Care Unit, Quzhou People's Hospital, Quzhou 324000, China |
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Abstract Objective To test whether the changes of transcutaneous partial pressure of oxygen（PtcO2）during passive leg raising（PLR）test evaluate fluid responsiveness. Methods Eighty－nine mechanically ventilated patients who need fluid evaluation admitted from January 2014 to December 2015 were prospectively recruited. Hemodynamic parameters monitored by a pulse indicator continuous cardiac output（PiCCO）device and PtcO2, monitored by an transcutaneous oxygen monitoring device were studied at baseline and after PLR. The correlation between PLR－induced CI change（△CI）and PtcO（2 △PtcO2）was analyzed by Pearson analysis. The value of △PtcO2 induced by passive leg raising to predict fluid responsiveness was evaluated by receiver operating characteristic（ROC）curves. Fluid responsiveness was defined as an increase in cardiac index（CI）of 15％ or greater after PLR（responders: △CI≥ 15％; nonresponders:△CI＜15％）. Results A total of 89 patients were enrolled in this study, of whom 52 had a CI increase of ≥ 15％ after PLR（responders）. After PLR, CI and PtcO2 were both sig⁃ nificantly increased in the response group compared with baseline （P＜0.05）, while no significant changes were observed in the non － response group（P＞0.05）. △ CI and △ PtcO2, after PLR were strongly correlated（r＝0.829，P＜0.05）. After PLR, the area under ROC curve of △PtcO2 was 0.911.An ncrease of ＞11.5% in △PtcO2 predicted fluid responsiveness with a sensitivity of 84.7％and speci⁃ficity of 90.4％. Conclusion The change of PtcO2 induced by PLR is a non－invasive and easy way topredict fluid responsiveness in critical patients.
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Received: 07 July 2016
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Corresponding Authors:
Zhang Wei－wen, E－mail: ZWW5941@126.com
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