Effect of positive end-expiratory pressure value on change in end-tidal carbon dioxide as a predictor of fluid responsiveness in Patients Undergoing Passive Leg Raising Maneuver

Lutfi Nur Farid (1), Hardiono Hardiono (2), Pesta Parulian Maurid Edwar (3)
(1) ,
(2) ,




Identification of patients’ fluid status in the emergency room should be made before giving fluid therapy. This study aimed to determine the effect of positive end-expiratory pressure on change in end-tidal carbon dioxide during passive leg raising maneuver to predict fluid responsiveness. Thirty subjects aged 18-65 years in the resuscitation room, all on the ventilator, were divided into three groups according to their positive end-expiratory pressure value: low (0-5 cmH2O), moderate (6-10 cmH2O), and high (>10 cmH2O). Every subject underwent passive leg raising to simulate fluid administration. Values of blood pressure, heart rate, cardiac output, and end-tidal carbon dioxide were recorded before and after the maneuver. Analysis of the three groups found a significant correlation between change in end-tidal carbon dioxide with a cut-off value of 5% and 1 mmHg with fluid responsiveness of subjects in the low (p = 0.028) and moderate (p = 0.013) but not in the high positive end-expiratory pressure group (p = 0.333). In conclusion, change in end-tidal carbon dioxide in mechanically ventilated patients undergoing passive leg raising maneuvers can be used as a predictor of fluid responsiveness, but this method cannot be used on patients with high positive end-expiratory pressure (> 10 cmH2O)


Keywords             : change in end tidal carbon dioxide, fluid responsiveness, positive end-expiratory pressure, passive leg raising, cardiac output surrogate

Correspondence   : lutfithe13th@gmail.com

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Lutfi Nur Farid
lutfithe13th@gmail.com (Primary Contact)
Hardiono Hardiono
Pesta Parulian Maurid Edwar
Farid, L. N., Hardiono, H., & Edwar, P. P. M. (2021). Effect of positive end-expiratory pressure value on change in end-tidal carbon dioxide as a predictor of fluid responsiveness in Patients Undergoing Passive Leg Raising Maneuver. Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya, 5(2). https://doi.org/10.30651/jqm.v5i2.5458

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