Hemodynamics, fluids & transfusion
Passive leg raising and microvascular skin blood flow to predict peripheral tissue perfusion fluid responsiveness
Authors' conclusion
In septic patients, PLR-induced changes in SBF reliably predict peripheral microvascular responsiveness to a subsequent volume expansion.
Study context
- Population
- Adults with sepsis requiring IV fluid administration, medical ICU, tertiary university hospital, Paris, France27 (73%) responders
- Participants
- 37 adults
- Comparison
- Passive leg raising (PLR)-induced change in fingertip skin blood flow (SBF) (ΔSBF-PLR) to predict microvascular fluid responsiveness to 500 mL saline
- Outcome
- Prediction of microvascular fluid responsiveness (responder: > 15% increase in SBF after volume expansion)
Methodological detailsprospective observational, single-centre
- Prospective observational
- Single-centre
Performance
As reported in the abstract
Prediction of fluid responsiveness
| Test or model | AUC | Sensitivity (threshold > 6%) | Specificity (threshold > 6%) | PPV | NPV |
|---|---|---|---|---|---|
| ΔSBF-PLR | 0.95 [0.86-1.00] (P < 0.001) | 96 [80-100] % | 90 [59-100] % | 96 [80-100] % | 91 [59-100] |
ΔSBF-PLR
AUC0.95 [0.86-1.00] (P < 0.001)
Sensitivity (threshold > 6%)96 [80-100] %
Specificity (threshold > 6%)90 [59-100] %
PPV96 [80-100] %
NPV91 [59-100]
Further findings
SBF change during PLR, responders
- SBF increased significantly during PLR in responders (ΔSBF-PLR)
- 40% [21-105]
- No significant changes in non-responders
Correlation of SBF changes with CO changes after volume expansion
- No correlation (R²)
- 0.04, P = 0.28
Original publication
Passive leg raising and microvascular skin blood flow to predict peripheral tissue perfusion fluid responsiveness. Crit Care. Published 21 January 2026. doi:10.
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