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<p>Passive leg raising (PLR) is a validated test of fluid responsiveness, but the value of brachiocephalic vein (BCV) distensibility as an ultrasound marker remains uncertain. In this prospective study, 129 volunteers were assessed for eligibility and 122 were analyzed (45 nonfasting controls, 77 fasting). Cardiac output (CO) was measured before and after PLR by echocardiography, and BCV distensibility was calculated from respiratory diameter variation. PLR increased CO in both groups (<i>P</i> &lt; 0.001). Median ΔCO was lower in fasting participants than in controls (21.05 [12.93–37.32] vs. 29.88 [22.13–39.86], <i>P</i> = 0.038), with lower responder rates at ΔCO ≥ 10% (79.2% vs. 95.6%, <i>P</i> = 0.016) and ΔCO ≥ 15% (74.0% vs. 91.1%, <i>P</i> = 0.032). ΔBCV distensibility did not differ between groups and was not associated with ΔCO overall (Spearman <i>r</i> = 0.148, <i>P</i> = 0.105). ROC analysis showed poor discrimination (AUC 0.38 overall, 0.51 in controls, 0.31 in fasting participants for ΔCO ≥ 15%), and exploratory adjusted analyses did not support an independent association between fasting status and responder status. BCV distensibility showed limited value and poor discriminatory performance as a marker of PLR-induced cardiac output change in spontaneously breathing healthy adults.</p>

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Brachiocephalic vein distensibility during passive leg raising in healthy adults

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月1日

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  • Ali Goksu,
  • Asli Bahar Ucar,
  • Mehmet Kocak,
  • Rasim Yorulmaz,
  • Tuba Cimilli Ozturk

摘要

Passive leg raising (PLR) is a validated test of fluid responsiveness, but the value of brachiocephalic vein (BCV) distensibility as an ultrasound marker remains uncertain. In this prospective study, 129 volunteers were assessed for eligibility and 122 were analyzed (45 nonfasting controls, 77 fasting). Cardiac output (CO) was measured before and after PLR by echocardiography, and BCV distensibility was calculated from respiratory diameter variation. PLR increased CO in both groups (P < 0.001). Median ΔCO was lower in fasting participants than in controls (21.05 [12.93–37.32] vs. 29.88 [22.13–39.86], P = 0.038), with lower responder rates at ΔCO ≥ 10% (79.2% vs. 95.6%, P = 0.016) and ΔCO ≥ 15% (74.0% vs. 91.1%, P = 0.032). ΔBCV distensibility did not differ between groups and was not associated with ΔCO overall (Spearman r = 0.148, P = 0.105). ROC analysis showed poor discrimination (AUC 0.38 overall, 0.51 in controls, 0.31 in fasting participants for ΔCO ≥ 15%), and exploratory adjusted analyses did not support an independent association between fasting status and responder status. BCV distensibility showed limited value and poor discriminatory performance as a marker of PLR-induced cardiac output change in spontaneously breathing healthy adults.