Respiratory failure & ventilation
Trendelenburg position is a reasonable alternative to passive leg raising for predicting volume responsiveness in mechanically ventilated patients in the intensive care unit (ICU)
Authors' conclusion
The Trendelenburg position (TRENDSUPINE and TRENDrTREND)-induced and PLR-induced percentage changes in SVI were similar in their ability to predict volume responsiveness in mechanically ventilated patients in the ICU.
Study context
- Population
- Mechanically ventilated ICU patients15 (42%) volume-responsive
- Participants
- 36 participants
- Exposure
- TRENDSUPINE vs TRENDrTREND vs passive leg raising (PLR)
- Outcome
- Prediction of volume responsiveness (≥15% SVI increase after 250 ml 4% albumin over 10 min) by ΔSVI (AUC)
Methodological detailssingle-centre, diagnostic accuracy
- Single-centre
- Diagnostic accuracy
Main finding
As reported in the abstract
Prediction of volume responsiveness
| Group | AUC | Sensitivity | Specificity | Cutoff |
|---|---|---|---|---|
| TRENDSUPINE | 0.78 (95% CI 0.59-0.92) | 93% | 67% | 4% |
| TRENDrTREND | 0.88 (95% CI 0.75-0.96) | 87% | 76% | 13% |
| PLR | 0.83 (95% CI 0.61-0.95) | 73% | 86% | 11% |
AUC
TRENDSUPINE0.78 (95% CI 0.59-0.92)
TRENDrTREND0.88 (95% CI 0.75-0.96)
PLR0.83 (95% CI 0.61-0.95)
Sensitivity
TRENDSUPINE93%
TRENDrTREND87%
PLR73%
Specificity
TRENDSUPINE67%
TRENDrTREND76%
PLR86%
Cutoff
TRENDSUPINE4%
TRENDrTREND13%
PLR11%
Observational data: associations, not effects.
Further findings
| Outcome | TRENDSUPINE | TRENDrTREND | PLR | P value |
|---|---|---|---|---|
| ΔSVI induced by each manoeuvreTRENDSUPINE vs TRENDrTREND | 6% | 16% | 11% | P < 0.001 |
| ΔSVI induced by each manoeuvreTRENDSUPINE vs PLR | P < 0.05 | |||
| Linear regression of ΔSVI vs volume loading test-induced ΔSVI (R2) | ||||
| R2 | 0.14 | 0.32 | 0.43 |
- Linear regression of ΔSVI vs volume loading test-induced ΔSVI (R2): all p < 0.001
Original publication
Trendelenburg position is a reasonable alternative to passive leg raising for predicting volume responsiveness in mechanically ventilated patients in the ICU. Crit Care. Published 4 February 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →