Neuroanesthesia & neurocritical care
The effect of passive leg raising test on intracranial pressure and cerebral autoregulation in brain injured patients: a physiological observational study
Authors' conclusion
In ABI patient with stable ICP, PLR test increased ICP, but mostly within safety values and thresholds. Despite this, cerebral autoregulation was importantly impaired, and this persisted up to 10 min after the end of the maneuvre.
Study context
- Population
- Critically ill patients with stable acute brain injury receiving invasive intracranial pressure (ICP) monitoring, multimodal neuromonitoring and continuous hemodynamic monitoring12 fluid responders
- Participants
- 23 patients
- Exposure
- After passive leg raising (PLR) vs baseline
- Outcome
- ICP, CPP and PRx
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- ICP increased, median (IQR) from 13.7 (8.3-16.4) to 15.4 (12.0-19.2) mmHg
- p < 0.001
- Cerebral perfusion pressure (CPP) increased, from 51.1 (47.4-55.6) to 56.4 (49.6-61.5) mmHg
- p < 0.001
- PRx increased, from 0.12 (0.01-0.24) to 0.43 (0.34-0.46)
- p < 0.001
Observational data: associations, not effects.
Further findings
Near Infrared Spectroscopy (NIRS)-derived parameters
- O2Hbi increased, from 1.8 (0.8-3.7) to 4.3 (2.5-5.6) μM cm
- P < 0.001
- HHbi increased, from 1.6 (0.2-2.9) to 2.7 (1.4-4.0) μM cm
- P = 0.007
- cHbi increased, from 3.6 (1.9-5.3) to 7.8 (5.2-10.3)
- P < 0.001
Correlations after PLR
- Significant correlation between MAP and CPP and PRx
- Spearman's rank test
Original publication
The effect of passive leg raising test on intracranial pressure and cerebral autoregulation in brain injured patients: a physiological observational study. Crit Care. Published 16 January 2024. doi:10.
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