Cardiovascular Medicine Book




Passive Leg Raise Maneuver

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

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