Passive Leg Raising Tests Under A Monitoring Device To Predict Fluid Responsiveness In Off-Pump Coronary Artery Bypass Grafting Patients

The debate concerning the surgical prognosis of passive leg raising tests with a supine position (PLRSU-PINE) under the MostCare/PRAM continuous non-invasive cardiac output monitoring system in the preoperative period of off-pump coronary artery bypass grafting (OPCABG) remains open. The present study aimed to investigate volume responsiveness, diagnostic cut-off values, and safety levels of PLRSUPINE in OPCABG patients. Hemodynamic data of 80 OPCABG patients with 156 times of PLRSUPINE was recorded using the MostCare/PRAM device. Of these, 85 PLRSUPINE instances were verified by volume expansion (VE) tests (250 mL colloid infusion in 15 minutes). According to results, VE yielded 59 positive results and 26 negative consequences. Mean percentage increases of stroke volume (SV) in VE, 85 verified PLRSUPINE, and 156 PLRSUPINE were 24.7 +/- 25.4%, 20.0 +/- 19.7, and 23.0 +/- 25.3%, respectively. The diagnostic cutoff value of increased SV in VE tests of 250 mL colloid infusion in 15 minutes was 12-14% of fluid responsiveness. PLRSUPINE under the MostCare/PRAM device is suitable for prediction of fluid responsiveness in the preoperative period of OPCABG. Diagnostic efficacy of stroke volume variation (SVV) and pulse pressure variation (PPV) was much lower than that of PLRSUPINE, with cut-off values of 9.2% in SVV and 11.2% in PPV. In conclusion, in the preoperative period of OPCABG, PLRSUPINE may cause lower efficacy in fluid responsiveness than VE testing with 250 mL colloid infusion in 15 minutes.