Passive leg raise may predict cardiac dysfunction in septic shock patients

March 20, 2019

Cheetah Medical, a Massachusetts-based provider of non-invasive fluid management devices has announced new results of a sepsis data analysis leveraging Cheetah Medical technology. The findings are being presented at the International Symposium on Intensive Care and Emergency Medicine (ISICEM), March 19-22, Brussels, Belgium. These data from the ongoing Fluid Responsiveness Evaluation in Sepsis-associated Hypotension (FRESH) study show that a simple bedside test of whether the heart can handle additional IV fluid (fluid responsiveness) may be helpful in identifying patients with underlying cardiac dysfunction.

In this analysis, approximately 95 to 100 percent of septic shock patients who did not demonstrate fluid responsiveness during the first 24 hours of hospital care had evidence of underlying cardiac dysfunction. Previous studies have demonstrated that the ability of the heart to handle additional IV fluid (fluid responsiveness) is dynamic – changing frequently in patients with septic shock. Fluid responsiveness can be assessed by performing a simple bedside maneuver called a Passive Leg Raise while monitoring cardiac stroke volume. These particular patients remained fluid non-responsive during the first 24 hours of observation. Sepsis is known to negatively impact cardiac function.

“These data indicate testing sepsis patients periodically for fluid responsiveness during the dynamic first 72 hours of a sepsis episode can be helpful in detecting any underlying cardiac dysfunction,” said Ivor Douglas, M.D., FRCP, Denver Health Medical Center. “We know cardiac function loss is a major risk for sepsis patients, so it’s advantageous for clinicians and for patient outcomes to have a method for identifying underlying cardiac deficits and loss of function as early as possible.”

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