Evaluation of Corrected Carotid Flow Time Variations During Passive Leg Lift to Predict Response to Filling.

Evaluation of Corrected Carotid Flow Time Variations During Passive Leg Lift to Predict Response to Filling

Patients hospitalized in intensive care often require intravenous administration of fluid in order to optimize the functioning of the heart and thus ensure perfusion of vital organs such as the kidneys, the brain or the digestive tract. However, it is necessary to find the right balance in fluid intake because it has been shown that excessive administration has a negative impact on patient survival, the length of their stay in intensive care or the duration of invasive mechanical ventilation.The passive leg lifting maneuver is regularly used to determine which patients should be infused with these large volumes (the patient's chest is placed in a horizontal position and the legs are elevated at 30 ° by tilting the bed for 2 minutes ). To be interpreted, this maneuver requires the presence of invasive devices (bloody arterial pressure catheter, PICCO monitor) or an operator experienced in cardiac ultrasound.Our study aims to evaluate an easy-to-use, non-invasive tool widely available in intensive care and emergency departments (carotid vascular doppler ultrasound) to assess the response to a passive leg lifting maneuver. . The measurements are taken before and after a passive leg lifting maneuver and then before and after a filling decided before inclusion by the doctor responsible for the patient.

Inclusion Criteria:

• equipped with a PICCO2® continuous cardiac output monitoring device
• for which the practitioner in charge of the patient decides to administer a volume expansion

Exclusion Criteria:

• patients whose rhythm is non-sinus
• who have expressed their refusal to participate in the protocol
• contraindicated to passive leg lifting maneuvers (deep vein thrombosis, HTIC, BMI> 40 or> 14, spinal instability)
• pregnant women and patients clinically suspected of abdominal compartment syndrome