Wednesday, January 25, 2017

Q: Hemodynamic management at bedside may be combined by doing Passive-Leg-Raising (PLR) test and observing change in End-tidal-CO2 - (EtCO2)

PLR test will

A) Increase the EtCO2
B) decrease  the EtCO2
C) Either increase or decrease in ETCO2 predicts hypovolemia
D) It need to be read by obtaining full Arterial Blood Gas (ABG) at same time
E) It is not possible to combine upper two entities


Answer: A

Though there is not a huge data available but at least one study has shown that if PLR testing increase the EtCO2 by five percent, it predicts a fluid-induced increase in Cardiac Index (CI)  with lesser sensitivity (71%) but 100% specificity.


Reference:

Monnet X, Bataille A, Magalhaes E, Barrois J, Le Corre M, Gosset C, Guerin L, Richard C, Teboul JL. End-tidal carbon dioxide is better than arterial pressure for predicting volume responsiveness by the passive leg raising test. Intensive Care Med. 2013 Jan;39(1):93-100

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