BACKGROUND: Fluid resuscitation is considered a cornerstone of shock treatment, but recent data have underlined the potential hazards of fluid overload. The passive leg raise (PLR) test has been introduced as one of many strategies to predict 'fluid responsiveness.' The use of PLR testing is applicable to a wide range of clinical situations and has the potential to reduce fluid administration, since PLR testing is based upon (reversible) autotransfusion. Despite these theoretical advantages, data on the net effect on fluid balance as a result of PLR testing remain scarce. METHODS: We performed a prospective single-center multi-step interventional study in @entity1 with @entity326 to evaluate the effect of implementation of PLR testing on the fluid balance (FB) 48 hours after ICU admission. All @entity1 were equipped with a PiCCO(  ) device for pulse contour analysis to guide fluid administration. An increase in @entity64 volume (SV) >=  10% was considered a positive test result. RESULTS: Before introduction of PLR testing, 21 @entity1 were prospectively included in period 1 with a median FB of 4.8 [3.3-7.8]L. After an extensive training program, PLR testing was introduced and 20 @entity1 were included in @entity5394 . Median FB was 4.4 [3.3-7.5]L and did not differ from period 1 (p = 0.72). Further analysis revealed that non-compliance to the PLR test result was 44%. These findings were discussed with all ICU doctors and nurses. By consensus, non-compliance to the PLR test result was identified as the main reason for unsuccessful implementation of PLR testing. After this evaluation, 19 @entity1 were included in period 3 under equal conditions as in @entity5394 . In this period, median FB was 3.1 [1.5-4.9]L and significantly reduced in comparison with @entity5394 (p = 0.016 and p = 0.023, respectively). Non-compliance was 9% and significantly lower than in @entity5394 (p = 0.009). CONCLUSION: Implementation of PLR testing in @entity1 with @entity326 reduced fluid administration in the first 48 hours of ICU admission significantly and substantially. To achieve this endpoint, substantial non-compliance of ICU team members had to be addressed. Fluid administration despite a negative PLR test was the most common form of non-compliance.

Passive leg raise testing effectively reduces fluid administration in XXXX after correction of non-compliance to test results.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity5394 :: ('8864', 'Gene') :: ['period 2', 'periods 1 and 2'] @entity326 :: ('MESH:D012772', 'Disease') :: ['septic shock']
@entity326 :: (MESH:D012772,Disease) :: ['septic shock']
