II. Indications
-
Hypotension or shock evaluation
- Predict volume responsiveness (that Hypotension will respond to fluid bolus)
III. Mechanism
- Adult lower extremity veins contain 150-200 ml blood per leg
- Elevation of both legs above the heart provides a transient autologous fluid bolus of 300-400 cc
IV. Technique: Passive Leg Raise (PLR)
- Start with patient in semirecumbent position
- Head of bed elevated 45 degrees and legs flat
- Measure hemodynamic parameters obtained
- See Inferior Vena Cava Ultrasound for Volume Status
- Obtain Blood Pressure and Heart Rate
- Arterial Line or other non-invasive hemodynamic monitoring parameters as available
- Reposition patient with both legs elevated
- Head of bed at 0 degrees flat and both legs elevated to 45 degrees
- Repeat hemodynamic parameter measurements as above
V. Interpretation
- Significant improvement in hemodynamic parameters following leg elevation suggests volume responsiveness